Thrombosis of the Inferior Vena Cava after Endovascular Aortic Repair in a Patient with May-Thurner Syndrome: Case Report and Literature Review

Inferior vena cava (IVC) thrombosis is a rare complication of abdominal aortic aneurysm (AAA). A 70-year-old male patient of Italian origin presented with a 9.3 × 8.4 cm infrarenal AAA, which was treated by endovascular aortic repair (EVAR). He reported a history of ulcerative colitis and was on prednisolone 80 mg daily. Seven weeks postoperatively the patient was readmitted with a deep vein thrombosis including both iliac veins and IVC, and bilateral pulmonary embolism. Venous thrombectomy and decompression of the IVC were performed by partial resection of the aneurysm sac. A covered stent was intraoperatively placed in the left common iliac vein to treat compression of the left iliac vein (May-Thurner Syndrome). Enoxaparin (2 × 0.8 mg) and antiplatelet agent with aspirin were administered, as well as intermittent compression therapy to the left leg. This case report describes vena cava thrombosis as a rare complication after EVAR in a patient with May-Thurner syndrome.