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Endovascular stent placement for nutcracker phenomenon.

Heping Li¹, Xiangzhou Sun, Guihua Liu

¹Department of Radiology, the First Affiliated Hospital of Sun Yat-Sen University, Guangzhou, Guangdong, China.

Journal of X-Ray Science and Technology

|March 20, 2013

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Nutcracker syndrome, a rare condition causing flank pain and hematuria, can be effectively treated with endovascular stenting. This minimally invasive approach successfully relieved symptoms in young patients, offering a viable alternative to surgery.

Area of Science:

Vascular Surgery
Interventional Radiology
Nephrology

Background:

Nutcracker syndrome is a rare condition characterized by left renal vein compression between the superior mesenteric artery and aorta.
Diagnostic criteria are often ill-defined, leading to delayed or missed diagnoses.
Surgical repair has been the traditional treatment, but endovascular stenting is emerging as an alternative.

Purpose of the Study:

To evaluate the efficacy and outcomes of endovascular stenting for managing nutcracker syndrome.

Main Methods:

Six patients (ages 7-31) with symptomatic nutcracker syndrome underwent endovascular stenting of the left renal vein.
Pre- and post-procedure assessments included laboratory tests and imaging (CT or ultrasound).

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Main Results:

Successful stent placement was achieved in all patients.
Significant increases in left renal vein diameter (1.88 to 5.24 mm) and decreases in pressure (11.00 to 6.00 mmHg) were observed post-procedure (p<0.01).
Complete resolution of gross hematuria and flank pain occurred within 2-6 months and 7 days-1 month, respectively.

Conclusions:

Endovascular stenting is a safe and effective treatment for symptomatic nutcracker syndrome.
This minimally invasive approach yields satisfactory long-term clinical and imaging results.