Left renal vein transposition for nutcracker syndrome

Reed, Nanette R.; Kalra, Manju; Bower, Thomas C.; Vrtiska, Terri J.; Ricotta, Joseph J.; Gloviczki, Péter

doi:10.1016/j.jvs.2008.09.051

Cited by 146 publications

(134 citation statements)

References 30 publications

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“…10 In pediatric age group, transposition of LRV was described as a novel e116 / Arch Argent Pediatr 2016;114(2):e114-e116 / Case report surgical procedure. 11 In our patient there were not a hematuria and additionally a varicocele did not occur. There was an intermittent pain complianment.…”

Section: Discussionsupporting

confidence: 47%

“…The cases which went under surgical or interventional treatment had hematuria or pelvic congestion syndrome. [8][9][10][11] The association of anterior and posterior nutcracker phenomene with the circumaortic LRV has only previously been described in the English literature on one occasion, in a middle-aged woman. 3 To the best of our knowledge, this is the first case described in an adolescent age patient group in the literature.…”

Section: Discussionmentioning

confidence: 99%

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Anterior and posterior nutcracker syndrome accompanying left circumaortic renal vein in an adolescent. Case report

Hayalioglu

2016

Arch Argent Pediat

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The left renal vein (LRV) has many developmental variations; the two most common are the circumaortic and the retrocaval. Anterior nutcracker syndrome is the compression of the LRV between the aorta and superior mesenteric artery, whereas posterior nutcracker syndrome occurs between the vertebral column and the aorta. An adolescent male (aged 16 years) was referred to the emergency department for flank pain. CT findings showed the combination of anterior and posterior nutcracker syndrome in the left circumaortic renal vein, which has not previously been described in an adolescent.

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Section: Discussionsupporting

confidence: 47%

Section: Discussionmentioning

confidence: 99%

Anterior and posterior nutcracker syndrome accompanying left circumaortic renal vein in an adolescent. Case report

Hayalioglu

2016

Arch Argent Pediat

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“…The first description of a proposed surgical treatment for the syndrome was published by Pastershank 18 in the 1970s and since then variations in the renal vein transposition technique have been described and reported as being effective surgical solutions 19 . Autotransplantation of the kidney is a more invasive technique, but it can produce excellent results.…”

Section: Discussionmentioning

confidence: 99%

Tratamento endovascular da Sindrome de Quebra-nozes (Nutcracker)

Cunha

Souza

Feitosa³

et al. 2013

J. vasc. bras.

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Nutcracker syndrome refers to signs and symptoms secondary to compression of the left renal vein, most commonly between the superior mesenteric artery and the aorta, leading to impaired outflow to the vena cava. Diagnosis of this syndrome is often difficult and as result is late in most cases. We report on the case of a 51-year-old woman successfully treated with embolization of the ovarian vein and insertion of a self expandable stent in the left renal vein. Technical details and pitfalls are discussed.Keywords: Nutcracker Syndrome; Nutcracker phenomenon; renal vein entrapment; Pelvic Congestion Syndrome. ResumoA Síndrome do Quebra-nozes se refere a um conjunto de sinais secundários à compressão da veia renal esquerda, mais comumente entre a artéria mesentérica superior e a aorta, levando ao comprometimento do fluxo para a veia cava. O diagnóstico desta síndrome frequentemente é difícil e, por esta razão, o diagnóstico é demorado, em muitos casos. É relatado, nesta publicação, o caso de uma mulher de 51 anos, tratada com sucesso pela embolização da veia ovariana associada ao implante de stent autoexpansível na veia renal esquerda. São discutidos os aspectos técnicos e as dificuldades do procedimento. phlebography showed the superior mesenteric artery pressing down on the left renal vein and significant dilation of the ovarian vein (Figures 2 and 3). The short sheath was changed for an 8F long sheath and selective catheterization of ovarian vein was conducted preparatory to embolization with a Renegade® microcatheter and release four 12×30 mm Interlock® springs, followed by infusion of 5 ml of 3% polidocanol in a dense foam (Figure 4). A 16 mm×60 mm self-expanding Wallstent® was then implanted in the left renal vein and angioplasty conducted with a 12×40 mm XXL balloon, taking care to maintain an anchorage area both proximally and distally, to avoid migration to the cava ( Figure 5). Control phlebography showed that satisfactory correction of left renal vein compression and Palavras-chave:

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“…47 Duplex ultrasound should be directed to image the obstruction as well as measure the ratio of PSV at the point of renal vein compression to the renal vein at the hilum. In the largest series published, 48 the mean PSV ratio was 7.3. A PSV ratio of 4.7 allows NCS to be diagnosed with 100% sensitivity and 90% specificity.…”

Section: Diagnosismentioning

confidence: 82%

“…A large series from the Mayo Clinic demonstrated the procedure's safety and efficacy for resolution of severe flank pain and hematuria. 48 The largest stenting experience to date is from China, 42 in which 15 patients with NCS were treated percutaneously, compared with 5 treated surgically. Transposition of the SMA was performed in 3 cases, transposition of the left renal vein in 2, and stent implantation in the left renal vein in 15.…”

Section: Treatmentmentioning

confidence: 99%

Nonatherosclerotic Obstructive Vascular Diseases of the Mesenteric and Renal Arteries

Escárcega

Mathur

Franco

et al. 2014

Clinical Cardiology

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Nonatherosclerotic vascular diseases of the mesenteric and renal arteries are considered to occur less frequently than those caused by occlusive atherosclerotic disease. However, when present, they pose a significant diagnostic and therapeutic challenge. Such disorders include fibromuscular dysplasia, median arcuate ligament syndrome, the renal nutcracker syndrome, and some forms of acute and chronic mesenteric ischemia (embolic and thrombotic). This is a heterogeneous group of disorders with substantial differences in the pathogenesis and diagnostic approaches to these diseases. We provide an overview of the pathogenesis, clinical presentation, diagnosis, and current management of fibromuscular dysplasia, median arcuate ligament syndrome, and the renal nutcracker syndrome.

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Left renal vein transposition for nutcracker syndrome

Cited by 146 publications

References 30 publications

Anterior and posterior nutcracker syndrome accompanying left circumaortic renal vein in an adolescent. Case report

Anterior and posterior nutcracker syndrome accompanying left circumaortic renal vein in an adolescent. Case report

Tratamento endovascular da Sindrome de Quebra-nozes (Nutcracker)

Nonatherosclerotic Obstructive Vascular Diseases of the Mesenteric and Renal Arteries

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