Left renal vein stent implantation for nutcracker syndrome

Objective To investigate the effectiveness of interventional therapy for nutcracker syndrome.MethodsFour male patients were clinically diagnosed as nutcracker syndrome whose age ranged from 17 to 26 years old.The clinical features were characterized by hematuria and microscopic proteinuria.Ultrasound showed that blood flow in the stenostic segment of the left renal vein was at high speed.CT scan clearly displayed that the angle of abdominal aorta and superior mesenteric artery was less than 30°,and left renal vein was compressed by the arteries.After angiography and pressure measurement,left renal vein stent implantation was performed trans-femoral or jugular vein.ResultsTechnical success was achieved in all patients.Left renal vein blood flow speed and pressure of patients became normal.Pressure difference of left renal artery stenosis descended from 10—16 mmHg to 0—3 mmHg.The clinical symptoms improved subsequently.During the follow-up of 6—12 months,the patients showed no symptom except 1 case having transient microscopic hematuria.ConclusionInterventional treatment is mini-invasive,safe and effective for nutcracker syndrome,and can be regarded as an alternative to surgical operation in some patients.