Amy Bonner\u2019s blood clot seemed to come out of nowhere. An innovative procedure saved her from a life of pain\u2014or worse.\nAmy Bonner is a vibrant, active advertising executive who loves to perform in community theater. She had no idea she was born with May-Thurner Syndrome, a rare condition of the lower vascular system until, at age 36, it caused a life-threatening blood clot in her left leg. \u201cI was just feeling lousy one night, right after dinner,\u201d she says. \u201cI decided to head upstairs and lie down. As I climbed the stairs, I noticed that my leg felt heavy, like it was asleep. I looked down at my leg, and it was purple.\u201d\nLearn more about the conditions treated at the UPMC Heart and Vascular Institute. \nPittsburgh\u2019s streets were glazed by an ice storm that evening and driving to the local ER was risky. So\nAmy called her health insurer\u2019s Nurse On Call service and described her symptoms. \u201cShe said to me, \u2018Honey, you should get to a hospital right now,\u2019\u201d Amy says. \u201cI was already listening to my own inner voice that told me this was more than a tired leg. It was that \u2018honey\u2019 that convinced me this was serious. That\u2019s when we got in the car.\u201d\nMay-Thurner Syndrome (MTS) is a kink in the plumbing caused when the left iliac vein, a large vein that moves blood from the left leg up toward the heart, is compressed by the overlying right iliac artery. Most people with this condition live a long life, never knowing they have it. It can cause discomfort, swelling, and pain that is never diagnosed.\nOr, as in Amy\u2019s cause, the bottlenecked vein can generate a serious blood clot called a deep vein thrombosis (DVT). DVT can mean more than a life of leg pain. If the clot breaks up and moves to the heart, lung or brain, DVT can quickly become a life-threatening event.\n\n\n\n\n6-Inch Blood Clot\nAt the ER, an ultrasound revealed a six-inch clot in Amy\u2019s left iliac vein, and she was transferred to UPMC Presbyterian Hospital, home of UPMC\u2019s nationally recognized Heart and Vascular Institute (HVI).\nThe HVI is where UPMC brings cardiologists, cardiac surgeons, and vascular surgeons together for collaborative research and clinical care that benefits heart and transplant patients as well as vascular patients like Amy. Having access to the HVI\u2019s multidisciplinary team of pulmonary specialists, interventional cardiologists, and cardiac and vascular surgeons helped ensure that the risk of DVT complications \u2014 such as pulmonary embolism \u2014 could be managed.\nAmy\u2019s case was referred to Rabih Chaer, MD, chief of vascular surgery at UPMC Presbyterian. \u201cMay- Thurner Syndrome is not very common, though awareness is increasing,\u201d says Dr. Chaer. \u201cIn western Pennsylvania, we\u2019ve seen maybe 50 cases over the last 10 years.\u201d This number of cases includes Amy\u2019s, which Dr. Chaer described as \u201cend stage.\u201d\n\u201cA clot like this typically appears when you\u2019re older, unless you have a condition like MTS,\u201d says Dr. Chaer. Standard treatment in an older patient would be a blood thinner, which would enable the patient to live with the clot and avoid an intervention.\nThe Goal: Quality of Life\n\u201cBut Amy is young,\u201d says Dr. Chaer. \u201cThe goal of care for her was to improve her quality of life.\u201d That meant a more innovative minimally invasive procedure: dissolving and removing the clot with drugs delivered through a catheter, followed by the placement of a stent to strengthen the vein and prevent further clotting.\nThe stent, typically used for arterial applications, hadn\u2019t been used widely for veins at the time of Amy\u2019s procedure, and it has proven to be effective. \u201cIt has lasted 10 years, with no complications,\u201d says Dr. Chaer.\n\u201cThe stent placement procedure was certainly far less invasive than surgery.\u201d Today, symptom-free and still active in local theater, Amy comes back to UPMC to see Dr. Chaer every year for a checkup and to stay current on developments in MTS.\nModern, Technology-Driven Vascular Care\nUPMC is also staying current \u2014 with clinical trials for venous application of two new types of stents. \u201cOne of our missions,\u201d says Dr. Chaer, \u201cis to be on the leading edge of modern, technology-driven vascular care.\u201d\nThat mission will be facilitated by UPMC\u2019s $2 billion investment in three new Pittsburgh hospitals to be completed in 2020, including an all-new Heart and Transplant Hospital that will further explore advances in molecular technology, imaging, and predictive modeling that translate into more personalized care for patients suffering from cardiovascular disease.