Hinojosa CA, Anaya-Ayala JE, Boyer-Duck E, Laparra-Escareno H, Torres-Machorro A, Lizola R. [Macroscopic hematuria secondary to nutcracker syndrome and successful endovascular treatment].
CIR CIR 2017;
85 Suppl 1:19-25. [PMID:
28040229 DOI:
10.1016/j.circir.2016.11.015]
[Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2016] [Accepted: 11/25/2016] [Indexed: 11/30/2022]
Abstract
BACKGROUND
Nutcracker syndrome is a rare entity, and in the majority of cases is the result of extrinsic compression of the left renal vein between the superior mesenteric artery and the aorta, associated with functional stenosis.
OBJECTIVE
To present the case of a 19-year-old female with no significant medical history with confirmed diagnosed of nutcracker syndrome treated successfully by endovascular means.
CLINICAL CASE
She was referred to the Vascular Surgery Department with a 6-month history of macroscopic haematuria, after other aetiologies were ruled out. Abdominal computed tomography angiography revealed compression of the left renal vein; the patient underwent endovascular treatment, and a 12×16 mm balloon expandable stent was placed with immediate angiographic improvement, decreased pressure gradients and progressive resolution of haematuria. At one year, she remains symptom-free.
CONCLUSION
Nutcracker syndrome is uncommon, and a high index of suspicion is needed. Macroscopic haematuria is not always present, and in our case stent placement demonstrated effectiveness in the resolution of symptoms at 12 months' follow--up. We also present a brief review of the literature.
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