{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,6]],"date-time":"2026-09-06T04:11:01Z","timestamp":1788667861514,"version":"build-2803163510"},"reference-count":14,"publisher":"SAGE Publications","issue":"9","license":[{"start":{"date-parts":[[2025,11,20]],"date-time":"2025-11-20T00:00:00Z","timestamp":1763596800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Angiology"],"published-print":{"date-parts":[[2026,10]]},"abstract":"<jats:p>May-Thurner syndrome (MTS) is an anatomical variant involving compression of the left iliac vein, predisposing to proximal deep vein thrombosis (DVT). Despite its clinical significance, population-level data remain limited. Using the RIETE (Registro Informatizado Enfermedad Trombo-Emb\u00f3lica) registry (2009-2024), we analyzed proximal DVT patients who underwent advanced imaging (CT-venography, contrast-venography, or MRI). Among 2872 patients with advanced imaging-confirmed proximal DVT, 124 (4.3%) had MTS. MTS patients were more likely to be female (78% vs 52%), younger (mean age 42 vs 62\u2009years), and to present with left-sided DVT (92% vs 46%). They had fewer comorbidities, but greater exposure to estrogen or pregnancy. Endovascular therapy was more frequently used in MTS patients (44% vs 3.5%), who also received longer median anticoagulation (365 vs 164\u2009days). Despite this, MTS patients had a significantly higher rate of recurrent DVT (rate ratio: 2.37; 95% CI 1.09-4.70). Multivariable analysis confirmed MTS as an independent predictor of recurrent DVT (adjusted hazard ratio: 2.26; 95% CI: 1.02-5.01). Major bleeding was non-significantly less frequent (rate ratio: 0.42; 95% CI: 0.13-1.04), though retroperitoneal bleeding was more common. MTS is underdiagnosed, has distinct clinical features and is associated with increased DVT recurrence despite aggressive therapy. Improved recognition and tailored management strategies are needed.<\/jats:p>","DOI":"10.1177\/00033197251392650","type":"journal-article","created":{"date-parts":[[2025,11,20]],"date-time":"2025-11-20T13:57:54Z","timestamp":1763647074000},"page":"1127-1133","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":1,"title":["Clinical Characteristics and Impact of May-Thurner Syndrome in Patients With Proximal Deep Vein Thrombosis: Insights From the RIETE Registry"],"prefix":"10.1177","volume":"77","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-4764-9440","authenticated-orcid":false,"given":"Jos\u00e9 F.","family":"Varona","sequence":"first","affiliation":[{"name":"Department of Internal Medicine, Hospital Universitario HM Monteprincipe, HM Hospitales, Spain"},{"name":"Instituto de Investigaci\u00f3n Sanitaria HM Hospitales, Madrid, Spain"},{"name":"Facultad HM de Ciencias de la Salud (CUHMED), Universidad Camilo Jos\u00e9 Cela, Madrid, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Cassius Iyad","family":"Ochoa Chaar","sequence":"additional","affiliation":[{"name":"Division of Vascular Surgery and Endovascular Therapy, Department of Surgery, Yale University School of Medicine, New Haven, CT, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jos\u00e9 Mar\u00eda","family":"Pedrajas","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, Hospital Clinico San Carlos, Madrid, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Giovanni","family":"Barillari","sequence":"additional","affiliation":[{"name":"Center for Hemorrhagic and Thrombotic Diseases, General and University Hospital S. Maria della Misericordia, Udine, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"A\u00edda","family":"Gil-D\u00edaz","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, Hospital Universitario de Gran Canaria Dr. Negr\u00edn, Las Palmas de Gran Canaria, Spain"},{"name":"Universidad de Las Palmas de Gran Canaria, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ana Cristina","family":"Montenegro Arenas","sequence":"additional","affiliation":[{"name":"Department of Vascular Medicine, Hospital Universitario Fundaci\u00f3n Santa Fe de Bogot\u00e1, Colombia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Juan Bosco","family":"L\u00f3pez-S\u00e1ez","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, Hospital Universitario de Puerto Real, C\u00e1diz, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hugo Hyung","family":"Bok Yoo","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine \u2013 Pulmonary Division, Botucatu Medical School \u2013 S\u00e3o Paulo State University (UNESP), Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Antoni","family":"Riera-Mestre","sequence":"additional","affiliation":[{"name":"Internal Medicine Department, Hospital Universitari Bellvitge, Barcelona, Spain"},{"name":"Bellvitge Biomedical Research Institute (IDIBELL), Barcelona, Spain"},{"name":"Clinical Sciences Department, Faculty of Medicine and Health Sciences, Universitat de Barcelona, Spain"},{"name":"Center for Biomedical Research in Obesity and Nutrition Physiopathology Network (CIBEROBN), Carlos III Health Institute, Madrid, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Manuel","family":"Monreal","sequence":"additional","affiliation":[{"name":"Chair for the Study of Thromboembolic Disease, Faculty of Health Sciences, UCAM \u2013 Universidad Cat\u00f3lica San Antonio de Murcia, Spain"},{"name":"CIBER Enfermedades Respiratorias (CIBERES), Madrid, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2025,11,20]]},"reference":[{"key":"e_1_3_4_2_2","doi-asserted-by":"publisher","DOI":"10.1177\/000331975700800505"},{"key":"e_1_3_4_3_2","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.2.5543.14"},{"key":"e_1_3_4_4_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jvs.2006.02.065"},{"key":"e_1_3_4_5_2","doi-asserted-by":"publisher","DOI":"10.1111\/jth.14707"},{"key":"e_1_3_4_6_2","doi-asserted-by":"publisher","DOI":"10.4103\/0366-6999.206341"},{"key":"e_1_3_4_7_2","doi-asserted-by":"publisher","DOI":"10.1177\/1358863X14560429"},{"key":"e_1_3_4_8_2","doi-asserted-by":"publisher","DOI":"10.1055\/a-0959-6230"},{"key":"e_1_3_4_9_2","doi-asserted-by":"publisher","DOI":"10.1007\/s12928-018-0532-y"},{"key":"e_1_3_4_10_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1615066"},{"key":"e_1_3_4_11_2","doi-asserted-by":"publisher","DOI":"10.1097\/MD.0000000000032646"},{"key":"e_1_3_4_12_2","doi-asserted-by":"publisher","DOI":"10.1160\/TH17-07-0511"},{"issue":"3","key":"e_1_3_4_13_2","article-title":"Systematic review of May Thurner syndrome with emphasis on gender differences","volume":"6","author":"Kaltenmeier CT","year":"2018","unstructured":"Kaltenmeier CT, Erben Y, Indes J, et al Systematic review of May Thurner syndrome with emphasis on gender differences. J Vasc Surg Venous Lymphat Disord. 2018;6(3):399-407.e4.","journal-title":"J Vasc Surg Venous Lymphat Disord"},{"key":"e_1_3_4_14_2","doi-asserted-by":"publisher","DOI":"10.1080\/16078454.2025.2548735"},{"issue":"4","key":"e_1_3_4_15_2","article-title":"May-Thurner syndrome and the risk of pulmonary embolism in patients with acute deep venous thrombosis","volume":"6","author":"Jin S","year":"2018","unstructured":"Jin S, Sun Z, Li X, et al May-Thurner syndrome and the risk of pulmonary embolism in patients with acute deep venous thrombosis. 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