Surgical Decompression for Non-thrombotic May-Thurner Syndrome in Hypermobile Ehlers-Danlos Patients When Stenting is not Advisable: History, Clinical Development, and Status Quo

May-Thurner Syndrome was originally defined by Robert May as a fibrotic valve like structure at the outflow of the left common iliac vein and was idiomatically preferred by May as'pelvic vein spur’ instead of ‘iliac vein compression syndrome.’ Today, the terminology named “May-Thurner syndrome” (MTS) has changed to thrombotic and non-thrombotic iliac vein lesions (NIVLs). Clinically, that is far away from the original description and allowed obviously liberal stentology. Recently, the VIVA foundation, the AVF, and the AVL Society published a consensus statement by which patient selection for NIVL stent placement may have a role in some cases with QOL - impacting chronic pelvic pain (CPP) of venous origin in the presence of dilated parauterine veins, with or without pelvic venous reflux.