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Related Experiment Videos

Endovascular stenting for the nutcracker phenomenon.

R Chiesa1, A Anzuini, E M Marone

  • 1Department of Vascular Surgery, Vita e Salute University, San Raffaele Hospital, Milan, Italy. roberto.chiesa@hsr.it

Journal of Endovascular Therapy : an Official Journal of the International Society of Endovascular Specialists
|January 19, 2002
PubMed
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Stent implantation effectively treats left renal vein (LRV) entrapment, or nutcracker phenomenon, resolving symptoms like hematuria. This endovascular approach offers a safe and valuable alternative to surgery.

Area of Science:

  • Vascular Surgery
  • Interventional Radiology
  • Nephrology

Background:

  • Left renal vein (LRV) entrapment, commonly termed nutcracker phenomenon, involves compression of the vein between the superior mesenteric artery and aorta.
  • This condition can lead to significant patient morbidity, including hematuria and flank pain.

Observation:

  • A 17-year-old male presented with gross hematuria and left flank pain.
  • Diagnostic imaging, specifically magnetic resonance angiography, confirmed LRV compression.
  • Initial stent placement with a Wallstent was insufficient, necessitating a second procedure.

Findings:

  • Successful stent implantation using a Memotherm stent restored adequate luminal flow in the LRV.
  • Post-procedure CT angiography at 6 months demonstrated LRV patency.

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  • The patient remained asymptomatic with complete resolution of hematuria at 12 months.

    • Implications:

    • Endovascular stenting is a safe and effective treatment for nutcracker phenomenon.
    • This minimally invasive technique can reduce the morbidity associated with surgical interventions.
    • Stent implantation presents a viable therapeutic option for managing symptomatic LRV entrapment.