ABSTRACT
Venous compression syndromes usually affect healthy young individuals. Venous obstruction leads to features of venous congestion with collateral formation. Venous compression may remain asymptomatic due to a collateral circulation or cause congestion with arm pain and swelling, hand cyanosis and enlarged shoulder and chest wall collaterals. Subclavian vein compression can lead to acute thrombosis known as the Paget–Schroetter syndrome or effort thrombosis. The May–Thurner syndrome usually results from compression of the left common iliac vein between the right common iliac artery and the sacral promontory or fifth lumbar vertebra just before the ilio-caval junction. Treatment for severe symptomatic compression is by surgical decompression through a posterior approach to the popliteal vein, with or without partial division of muscle bands. Computed tomography and magnetic resonance venography both have high sensitivity and specificity to identify venous compression and pelvic venous collaterals and for ilio-femoral thrombosis.
