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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
Purpose:
To present a case highlighting the efficacy of stent implantation for left renal vein (LRV) entrapment, otherwise known as the nutcracker phenomenon.
Case Report:
A 17-year-old boy presented with a history of gross hematuria and left flank pain. Magnetic resonance angiography documented compression of the LRV between the superior mesenteric artery and aorta. A Memotherm stent was successfully placed across the LRV to restore adequate luminal flow after a Wallstent failed to adequately span the narrowed segment. Spiral CT angiography at 6 months confirmed LRV patency; the patient remains asymptomatic and free of hematuria at 12 months.
Conclusions:
Endovascular stenting for the nutcracker phenomenon is safe and effective and may represent a valuable approach for lessening the morbidity of surgical procedures.