Compression syndromes play an important role in pelvic venous disease (PeVD). Although compressive lesions of the common iliac and renal veins are common on non-invasive imaging studies, they are usually asymptomatic and the factors associated with the development of symptoms remain poorly understood. The prevalence of pelvic or lower-extremity symptoms and varicose veins caused by compression of an iliac or left renal vein is unknown. However, a high index of suspicion is needed in the work-up of PeVD, particularly in patients who are refractory to the initial treatment. Once a symptomatic compression syndrome is discovered in a PeVD patient, this should be treated first.
After treating compression syndromes, there should be a waiting period to notice if the complaints and symptoms diminish.
Key words: May-Turner, Nutcracker, PeVD, venous compression syndromes.
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