Anion gap not great for lactic acidosis

Interesting study from 1990 showing that anion gap is not sensitive as a screening for lactic acidosis in a critically ill patients

May-Thurner syndrome

50 yo female with no prior medical history p/w left lower extremity swelling. She is found to have a DVT extending from the external iliac to the posterior tibial vein, big clot! 

The radiologist thought it could be due to compression of iliac vein between the spine and iliac artery => May-Thurner syndrome.

What to do about that? 

A case report and review of literature suggests that:

"Endovascular therapy is the current mainstay of treatment for May-Thurner syndrome. Review of the current literature supports treatment via catheter-directed thrombolysis followed by stent placement with good early results."

A review from Annals of Vascular Surgery suggest:

"Treatment is based on the clinical presentation and includes staged thrombolysis with/without prophylactic retrievable inferior vena cava filter placement, followed by angioplasty/stenting of the left iliac vein in MTS patients with extensive DVT"