Anterior nutcracker syndrome in the setting of a duplicated inferior vena cava

Abstract

Nutcracker syndrome is a rare vascular disorder that involves compression of the left renal vein (LRV), most often at the level of the aortomesenteric angle. In some cases, this compression syndrome arises in the setting of unusual vascular anatomic variants. We describe the case of a 43-year-old woman with a duplicated inferior vena cava who was found to have LRV compression on magnetic resonance angiography and venography with intravascular ultrasound. The patient was successfully treated with concurrent transposition of the LRV and left-sided inferior vena cava, with complete resolution of symptoms. (J Vasc Surg Cases and Innovative Techniques 2020;6:121-5.)

Wilkie Syndrome and Pseudo-Nutcracker Syndrome a Rare Combination: Description of a Case

“…There is a cut-off value (22°) of AMA and a cut-off value (8 mm) of aorto-mesenteric distance (AMD), below which duodenal compression occurs with consequent sub-occlusive crisis, postprandial vomiting, and nausea that promote weight loss [ 2 ]. MAS reduction can also cause LRV compression which, if hemodynamically significant, becomes symptomatic causing left flank pain, microhematuria, secondary varicocele, and thrombosis; this pathological condition is known as anterior nutcracker syndrome (ANCS) [ 3 ]. Osteophytes, aortic aneurysms, or surgical outcomes can narrow the aorto-vertebral space (AVS) causing compression of the left retroaortic renal vein [ 4 ], if compression is severe and symptomatic, provokes so-called pseudo-nutcracker syndrome (PNCS) [ 5 ].…”

Estudo das relações anatômicas entre a artéria mesentérica superior e a veia renal esquerda em população de indivíduos doadores renais por meio de angiotomografia computadorizada multislice

“…A mensuração do diâmetro da VRE, apesar da facilidade e simplicidade como método de estudo para redução da luz vascular, não é tão fidedigna para compreensão hemodinâmica como a análise de sua área, como comprovado em trabalhos utilizando ultrassom intravascular (IVUS) para estudo de evento compressivo no território venoso [76][77][78][79] O cálculo da área (A) de uma estrutura cilíndrica/circunferencial é obtida a partir da fórmula geométrica 83 : A = p r 2 ; p = 3,1416; r = diâmetro/2…”