{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,10]],"date-time":"2026-10-10T02:48:55Z","timestamp":1791600535566,"version":"4.3.4"},"reference-count":26,"publisher":"MDPI AG","issue":"19","license":[{"start":{"date-parts":[[2026,9,28]],"date-time":"2026-09-28T00:00:00Z","timestamp":1790553600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,9,28]],"date-time":"2026-09-28T00:00:00Z","timestamp":1790553600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["J. Clin. Med.","JCM"],"abstract":"<jats:p>Background: May\u2013Thurner syndrome (MTS) is an uncommon cause of deep vein thrombosis and unilateral lower extremity lymphedema. We present the largest case series to date of 26 MTS patients with lymphedema. We aim to report the pathophysiology of lymphedema in relation to venous dysfunction onset in MTS patients and evaluate the effectiveness of surgical lymphedema treatment. Methods: Retrospective case series. Patients treated for lymphedema with concurrent MTS diagnosis were retrospectively identified at a large academic medical center. Surgical interventions included lymphovenous anastomosis (LVA), vascularized lymph node transfer (VLNT), liposuction, and a combination of surgeries. Nonsurgical intervention included complete decongestive physical therapy (CDPT). Results: Twenty-six patients (19 female, seven male) were identified and had undergone prior iliac vein stenting. International Society of Lymphology (ISL) stage II\u2013III patients underwent lymphatic surgery or CDPT, while stage I only underwent CDPT. Stage I patients demonstrated an average excess volume increase of 21.74% \u00b1 23.11. In stage II, CDPT patients experienced a percent volume increase of 15.26% \u00b1 11.06, while combination patients experienced a 102% \u00b1 63.31 volume decrease. Stage III patients comprised CDPT, liposuction, VLNT, and combination; these groups and two of three VLNT patients demonstrated decreased limb volume percentage. Pre- and postoperative MRIs in surgically treated patients showed improved tissue bulk, edema reduction, and new lymphatic channel formation. Conclusions: Surgery was effective in reducing MTS-related lymphedema. The common co-occurrence of lymphedema and MTS presents an opportunity for screening, early intervention, and prospective studies.<\/jats:p>","DOI":"10.3390\/jcm15197546","type":"journal-article","created":{"date-parts":[[2026,9,28]],"date-time":"2026-09-28T16:50:54Z","timestamp":1790614254000},"page":"7546","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Lymphedema Management in May\u2013Thurner Syndrome: A Case Series of 26 Patients"],"prefix":"10.3390","volume":"15","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-6359-2611","authenticated-orcid":false,"given":"Sabrina Valentina","family":"Lazar","sequence":"first","affiliation":[{"name":"Department of Surgery, University of Massachusetts Chan Medical School Program, Worcester, MA 01655, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0006-0406-9285","authenticated-orcid":false,"given":"Elizabeth","family":"Tadevosyan","sequence":"additional","affiliation":[{"name":"Division of Plastic and Reconstructive Surgery, Stanford University School of Medicine, Palo Alto, CA 94304, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0000-9294-2203","authenticated-orcid":false,"given":"Nitya","family":"Devisetti","sequence":"additional","affiliation":[{"name":"Rutgers New Jersey Medical School, Newark, NJ 07103, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0007-8486-4568","authenticated-orcid":false,"given":"Subin","family":"Cho","sequence":"additional","affiliation":[{"name":"Division of Plastic and Reconstructive Surgery, Stanford University School of Medicine, Palo Alto, CA 94304, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sirish","family":"Kishore","sequence":"additional","affiliation":[{"name":"Department of Radiology, Stanford University School of Medicine, Palo Alto, CA 94305, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Carrie","family":"Kubiak","sequence":"additional","affiliation":[{"name":"Department of Plastic Surgery, Vanderbilt University Medical Center, Nashville, TN 37232, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9494-7523","authenticated-orcid":false,"given":"Dung Hoang","family":"Nguyen","sequence":"additional","affiliation":[{"name":"Division of Plastic and Reconstructive Surgery, Stanford University School of Medicine, Palo Alto, CA 94304, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2026,9,28]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","unstructured":"Kim, T.I., Tonnessen, B.H., and Chaar, C.I.O. 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