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Robot-assisted extravascular stent for nutcracker syndrome: A case report.

João Pádua Manzano^1,2, João Henrique Sendrete de Pinho³, Thainã de Oliveira Azambuja²

¹Federal University of São Paulo, São Paulo, Brazil.

Urology Case Reports

|January 6, 2023

Summary

Nutcracker syndrome (NCS), a rare left renal vein compression, was treated in a young woman using robotic extravascular stent placement. This minimally invasive approach successfully relieved her chronic pain and prevented further vein compression over 30 months.

Keywords:

CT, Computed Tomography Scan Extravascular stent LRV, Left Renal Vein NCS, Nutcracker Syndrome Nutcracker syndrome PTFE, Polytetrafluoroethylene Robot-assisted surgery

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Area of Science:

Vascular Surgery
Urology
Minimally Invasive Surgery

Background:

Nutcracker syndrome (NCS) involves left renal vein (LRV) compression between the aorta and superior mesenteric artery.
Surgical intervention for NCS is typically reserved for severe, refractory cases.

Observation:

A 31-year-old woman with adolescent-onset NCS experienced persistent left flank pain and microhematuria.
Symptoms included 30 days of severe left flank pain and microhematuria.

Findings:

The patient underwent successful robotic-assisted extravascular stent placement around the LRV.
Follow-up at 30 months showed complete resolution of pain.
The LRV remained uncompressed and free of thrombosis post-procedure.

Implications:

Robotic extravascular stent placement offers a promising minimally invasive surgical option for NCS.
This technique can provide long-term symptom relief and maintain LRV patency.
Further research may establish this as a viable alternative to traditional surgical methods.