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American Journal of Case Reports is ranked the World leading among journals dedicated to publishing clinical case reports. AJCR is indexed in Web of Science, PubMed/ PMC, Scopus

(1) CiteScore (Impact Factor - like by Scopus, Elsevier) is the number of citations received by a journal in one year to documents published in the three previous years, divided by the number of documents indexed in Scopus published in those same three years.

(2) SNIP (Source Normalized Impact per Paper) measures a source’s contextual citation impact by weighting citations based on the total number of citations in a subject field. It helps you make a direct comparison of sources in different subject fields. SNIP takes into account the characteristics of the source's subject field, which is the set of documents citing that source.

(3) SJR is weighted by the prestige of a journal. Subject field, quality, and reputation of the journal have a direct effect on the value of a citation. SJR assigns relative scores to all of the sources in a citation network. Its methodology is inspired by the Google PageRank algorithm, in that not all citations are equal. A source transfers its own 'prestige', or status, to another source through the act of citing it. A citation from a source with a relatively high SJR is worth more than a citation from a source with a lower SJR. 

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Clinical case reports are an invaluable first-hand source of evidence in medicine and a tool most often used in practice to exchange information and generate a more expanded search for evidence. In addition to the “evidence of what happened”, single or multiple cases are an important basis for further and more advanced research on diagnosis, treatment effectiveness, causes and outcomes of disease. However limited their conclusions may be, case reports remain a fundamental component of medicine, contributing greatly to the advancement of health care. In today's ever-expanding Evidence-Based Medicine, case reporting require a well-defined focus, content, and structure.

Presently, only a fraction of case reports is useful for clinical decision-making and bedside-decision oriented research. Therefore, the aim of the Journal is to gather case reports across medical disciplines, thereby integrating interdisciplinary, international medical knowledge.


Published: 2019-05-19

Endovascular Management of May-Thurner Syndrome in a Patient with Left-Sided Superior Vena Cava: A Case Report

Mamoon H. Al-Omari, Qusai M. Aljarrah, Jehad Fataftah, Bashar Ghosheh, Zaid Manasara

(Department of Radiology, Jordan University of Science and Technology, King Abdullah University Hospital, Irbid, Jordan)

Am J Case Rep 2019; 20:713-718

DOI: 10.12659/AJCR.915724


BACKGROUND: May-Thurner syndrome (MTS) is a condition characterized by compression of the left common iliac vein (LCFV) between the right common iliac artery (RCIA) and the lumbar vertebrae. This anatomical entrapment typically affects young women and is mostly asymptomatic. High index of suspicion is required in cases of recurrent left-sided deep vein thrombosis (DVT) and severe leg pain. We describe a case of MTS in a young male patient with a left-sided superior vena cava (LSSVC) that was successfully managed by an endovascular approach. To the best of our knowledge, the coexistence of MTS and LSSVC anomaly has not been reported previously.
CASE REPORT: A 31-year-old man presented with a history of left-sided iliofemoral deep vein thrombosis and disabling venous claudication of 2 years’ duration. Duplex ultrasound and computed tomography venogram (CTV) revealed evidence of MTS with chronic subtotal occlusion of the left common iliac vein (LCIV) with extensive venous collaterals. Venogram via the left femoral vein puncture confirmed the aforementioned findings. Retrograde recanalization of the occluded segment was attempted without success. Therefore, an antegrade approach via the right internal jugular vein was performed to facilitate recanalization. Surprisingly, venography revealed an LSSVC. The occluded CIV was successfully stented and the patient had complete resolution of his symptoms at 22-month follow-up.
CONCLUSIONS: MTS is a potentially treatable and often-overlooked pathology. In the era of expanded endovascular management of MTS, recognition of this coincidence is essential to prevent unwarranted mishaps during endovascular management when the jugular approach is used.

Keywords: endovascular procedures, Jugular Veins, May-Thurner Syndrome, Stents, Vena Cava, Superior, Venous Thrombosis



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