Endovascular stenting for the nutcracker phenomenon.
OBJECTIVE
To present a case highlighting the efficacy of stent implantation for left renal vein (LRV) entrapment, otherwise known as the nutcracker phenomenon.


METHODS
A 17-year-old boy presented with a history of gross hematuria and left flank pain. Magnetic resonance angiography documented compression of the LRV between the superior mesenteric artery and aorta. A Memotherm stent was successfully placed across the LRV to restore adequate luminal flow after a Wallstent failed to adequately span the narrowed segment. Spiral CT angiography at 6 months confirmed LRV patency; the patient remains asymptomatic and free of hematuria at 12 months.


CONCLUSIONS
Endovascular stenting for the nutcracker phenomenon is safe and effective and may represent a valuable approach for lessening the morbidity of surgical procedures.
Chiesa
R
R
Department of Vascular Surgery, Vita e Salute University, San Raffaele Hospital, Milan, Italy. roberto.chiesa@hsr.it
Anzuini
A
A
Marone
E M
EM
Briguori
C
C
Moura
M R
MR
Melissano
G
G
Colombo
A
A
Rosanio
S
S
D000293:Adolescent; D003251:Constriction, Pathologic / Q000150:complications / Q000000981:diagnostic imaging / Q000628:therapy; D006417:Hematuria / Q000209:etiology; D006801:Humans; D018810:Magnetic Resonance Angiography; D008297:Male; D010146:Pain / Q000209:etiology; D011859:Radiography; D012082:Renal Veins / Q000000981:diagnostic imaging; D015607:Stents; D014654:Vascular Patency