Are You Suffering From Iliac Vein Obstruction? Here’s What You Need to Know

Medically reviewed by Vinit S. Shah, DO, on September 25, 2025

Your legs may be trying to tell you something. Listen to them.

If you’ve been living with unexplained swelling, heaviness, or varicose vein pain, you might have more than a cosmetic issue. Iliac vein obstruction, also known as iliac vein compression syndrome or May-Thurner syndrome, happens when the large veins in your pelvis become narrowed or blocked, reducing blood return from the legs.

The good news? The board-certified vein specialists at Center for Vein Restoration (CVR) offer advanced diagnostics and minimally invasive treatments to restore healthy blood flow and relieve symptoms.

We consulted with Dr. Vinit Shah, a vein expert at Center for Vein Restoration, regarding iliac vein obstruction (May-Thurner syndrome). Dr. Shah is the lead physician at CVR vein clinics in Edison, New Jersey, East Brunswick, New Jersey, and Freehold, New Jersey.

Trusted Expertise, Advanced Vein Care

Don’t settle for guesswork! At Center for Vein Restoration (CVR), we combine compassionate care with state-of-the-art technology to find the real cause of your leg pain, swelling, or varicose veins. As America’s largest physician-led vein center, we make advanced vein care convenient and accessible.

What Is Iliac Vein Compression Syndrome (May-Thurner Syndrome)?

According to the American Venous Forum, our iliac veins carry blood from each leg into the abdominal cavity, where they join to form the inferior vena cava, the major vein that returns blood to the heart. These veins lie behind the iliac arteries and in front of the spine. In some people, the right iliac artery crosses over and presses on the left iliac vein, squeezing it between the artery and the spine.

This “anatomical pinch point” slows blood flow and can lead to narrowing, scarring, or clotting in the vein. While May-Thurner syndrome is the most common cause, other causes of iliac vein compression include tumors or scar tissue in the pelvis.

Think of it like stepping on a garden hose: the flow slows down or stops, and blood backs up in your leg, causing swelling, pain, and, over time, complications such as deep vein thrombosis (DVT), which is a blood clot in the deep vein typically in the leg.

Get Same-Day Peace of Mind with CVR’s DVT Rule-Out Service

Worried you might have a blood clot? Don’t wait for hours in the ER. Center for Vein Restoration (CVR), America’s largest physician-led vein treatment network, offers same-day DVT screening and care so you can get answers and treatment fast.

Our one-stop DVT rule-out appointment includes:

• Immediate diagnostic scan to confirm or rule out a clot
• On-the-spot anticoagulation treatment if needed
• Clear education about your results and next steps
• Follow-up care to keep you safe and supported

📞 Take control of your health today. Call CVR’s DVT Hotline at 877-SCAN-DVT (877-722-6388).

Who Treats Iliac Vein Obstruction?

This condition requires expertise from doctors trained in blood vessel disorders and advanced imaging techniques:

• Vascular Surgeons – Experts in diagnosing and performing complex interventions, including venous stenting to reopen blocked veins.
• Interventional Radiologists – Specialists who use imaging guidance to perform minimally invasive procedures like clot removal and stent placement.
• Vascular Specialists (Phlebologists) – CVR’s board-certified physicians focus exclusively on vein health, serving patients in 120+ dedicated vein clinics across the country.

Choosing a clinic staffed by board-certified vein doctors ensures you receive a precise diagnosis and effective treatment under one roof.

👉 Don’t wait! Schedule your consultation with a CVR vein specialist today and get the answers—and relief—you’ve been waiting for.

Symptoms You Shouldn’t Ignore

Many people dismiss leg symptoms as normal aging, but iliac vein obstruction has a pattern worth recognizing:

• Persistent swelling in one leg (often the left)
• Heaviness, throbbing, or aching pain that worsens after sitting or standing
• Varicose veins or spider veins that keep coming back
• Darkening of the skin, warmth, or ulcers near the ankle
• Pelvic or lower back pain, especially in women, after standing for long periods

Because these symptoms often overlap with other vein conditions like pelvic congestion syndrome, getting the correct diagnosis is key.

📞 Call Center for Vein Restoration at 240-965-3915 
📅 Or book online HERE

How Specialists Diagnose Iliac Vein Obstruction

Your physician or advanced practice provider will start by taking a detailed medical history and performing a physical exam. Then, they may order one or more of these tests:

• Leg ultrasound – Screens for clots and abnormal flow; may suggest pelvic venous disease.
• Pelvic ultrasound – Screens for venous obstruction in pelvic veins.
• CT or MR venography – 3D imaging that shows the exact anatomy and location of compression.
• Venogram with IVUS (intravascular ultrasound) – The gold standard for diagnosis, using a tiny probe inside the vein to measure narrowing and guide treatment decisions.

This comprehensive approach ensures that any deeper problem is identified before moving forward with vein treatment.

Modern Treatment Options

Treatment begins with improving blood flow and relieving symptoms:

• Lifestyle measures: Compression stockings, leg elevation, frequent walking, and avoiding long periods of standing or sitting can help. Maintaining a healthy weight also reduces pressure on your veins.
• Medication: In some cases, doctors prescribe medicines to reduce swelling or blood thinners if a clot is present.
• Venous stenting: The most common treatment for May-Thurner syndrome. During a minimally invasive procedure, your doctor inserts a tiny balloon to open the vein and places a mesh stent to keep it open. Some patients experience mild low back discomfort for a few days after the procedure as the vein adjusts.
• Clot removal procedures: If a DVT is present, specialists may remove or dissolve the clot before placing the stent.

Because these procedures are guided by live imaging, they are highly precise and typically done under local anesthesia or light sedation, with same-day discharge.

Why Early Treatment Matters

A study titled Iliac Vein Compression Syndrome, published via the National Library of Medicine (NIH), shows that patients who are treated early have much better outcomes and fewer long-term complications such as post-thrombotic syndrome.

Early diagnosis and treatment can restore blood flow, prevent complications, and dramatically improve quality of life.

• DVT and pulmonary embolism (PE) – potentially life-threatening blood clots
• Chronic venous insufficiency – damage to vein valves that causes ongoing varicose veins and skin changes
• Skin ulcers – painful wounds that can take months to heal

Iliac vein obstruction isn’t just about pain or swelling; it’s about protecting your long-term health.

Iliac Vein Obstruction: Key Takeaways and Next Steps

Iliac vein obstruction is common, underdiagnosed, and highly treatable. If you have stubborn leg swelling, problem veins, or pelvic pain, don’t ignore it—get evaluated by a vascular surgeon, interventional radiologist, or board-certified vein doctor, like the vein health professionals at CVR.

With advanced imaging like CT venography and IVUS, and minimally invasive procedures, most patients experience rapid symptom relief and get back to normal activities quickly.

Take The First Step Toward Healthy, Pain-Free Legs

Center for Vein Restoration is the trusted leader in vein care, delivering minimally invasive, outpatient treatments that work. Most major insurance plans are accepted, so there’s no reason to wait. Book your appointment today!