Recurrent Deep Vein Thrombosis in May Thurner Syndrome Precipitated by Heparin Induced Thrombocytopenia: A Case Report and Review of Literature

May Thurner Syndrome involves the extrinsic compression of the left common iliac vein by the right common iliac artery, which predisposes to venous thrombosis. This case report and review of literature details a complex instance of recurrent Deep Vein Thrombosis (DVT) in a 58-year-old female patient with May Thurner Syndrome (MTS), exacerbated by Heparin-Induced Thrombocytopenia (HIT). The patient, post Coronary Artery Bypass Graft surgery, developed leg symptoms leading to the discovery of an extensive DVT from the calf veins to the external iliac vein. She was initially treated with heparin, which was switched to bivalirudin following a significant drop in platelet count, indicative of HIT. Despite undergoing thrombectomy and stenting, the patient experienced a recurrence of thrombosis, necessitating further interventions, including re-stenting and continued anticoagulation management. This case underscores the complexity of managing DVT in patients with MTS, particularly when complicated by HIT, and highlights the importance of vigilant monitoring and tailored therapeutic strategies to manage the thrombotic risks associated with this syndrome.