Hybrid intervention for treatment of the nutcracker syndrome.

J Vasc Surg Cases

Division of Vascular and Endovascular Surgery, Mayo Clinic, Rochester, Minn.

Published: December 2015

Nutcracker syndrome is a rare anomaly resulting from compression of the left renal vein between the aorta and the superior mesenteric artery. Open and endovascular interventions have both been performed to relieve the compression. Each of these interventions has strengths and weaknesses. We report two patients in whom a hybrid approach was adopted in the process combining the strengths of each intervention while reducing potential complications.

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http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6849905PMC
http://dx.doi.org/10.1016/j.jvsc.2015.08.005DOI Listing

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Nutcracker syndrome (NCS) is an uncommon vascular condition caused by the compression of the left renal vein (LRN), which may result in venous hypertension and clinical symptoms, including hematuria, flank pain, and pelvic congestion. This report describes the case of a 30-year-old woman with recurrent painless macroscopic hematuria, ultimately diagnosed with NCS based on clinical and radiological findings. Computed tomography (CT) angiography revealed a reduced aortomesenteric angle and LRN compression without signs of severe venous hypertension or collateral circulation.

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