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Updated: Apr 20, 2026

A Novel Method: Super-selective Adrenal Venous Sampling
Published on: September 15, 2017
A case of secondary hypertension associated with the nutcracker phenomenon
Se-Jun Park1, Sun-Mi Kim1, Je-Hwan Won2
1Department of Cardiology, Ajou University School of Medicine, Suwon, Korea.
Abstract:
A 25-year-old Korean woman was referred for uncontrolled hypertension. Laboratory examination revealed increased plasma renin activity and microscopic hematuria. Computed tomography demonstrated compression of the left renal vein (LRV) between the aorta and superior mesenteric artery; however, both renal arteries were intact and there was no adrenal mass. Renal vein catheterization showed external compression with a pressure gradient of up to 8 mm Hg between the LRV and the inferior vena cava. Plasma renin activity in the LRV was almost five times higher than that in the right renal vein. In this patient, renin-dependent hypertension was caused by renal congestion due to LRV obstruction.
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