evaluate and diagnose these conditions. Their clinical manifestations are usually underestimated, mainly by their low prevalence, clinicians' low level of knowledge and symptoms unspecificity.
When these entrapments become symptomatic, they result in a spectrum of syndromes, such as Median Arcuate Ligament Syndrome (MALS), Nutcracker Syndrome (NS), Superior Mesenteric Artery Syndrome (SMAS) and May-Thurner Syndrome (MTS).
Median Arcuate Ligament Syndrome (MALS) consists of compression of the celiac artery by the median arcuate ligament (Figures 1-2). Superior Mesenteric Artery Síndrome (SMAS) consists of compression of the duodenum between the aorta and superior mesenteric artery (SMA) (Figures 3-4).Nutcracker Syndrome consists of the entrapment of the left renal vein (LRV) between the SMA and the aorta (anterior) (Figures 5-6) or entrapment of the retro-aortic LRV between the aorta and vertebral bodies (posterior) (Figures 7-8). May-Thurner syndrome consists of compression of the left common iliac vein between the right common illiac artery and L5 (Figure 9-10), and is also known as Cockett syndrome when there is associated thrombosis.Each AVCS has its particular epidemiology, clinical manifestations, and diagnostic criteria (Figures 1, 3, 5, 7, and 9). They are represented with CT images and 3D-reconstructions (Figures 2, 4, 6, 8, and 10).
Early diagnosis is important in order to avoid complications, and to indicate the appropriate treatment. Failure to identify these conditions can expose patients to significant morbidity.Surgery is the main treatment option, except in conditions which the patient has mild symptoms that allow conservative management, or does not tolerate a surgical procedure.