title: Endovascular stenting for treatment of Nutcracker syndrome: report of 61 cases with long-term followup.
abstract: OBJECTIVE
  We report the efficacy and safety of endovascular stenting for nutcracker syndrome at long-term followup.
  
  
  METHODS
  We retrospectively evaluated the endovascular stenting experience with 61 patients with a median age of 26 years. Symptoms were hematuria, proteinuria or flank pain. Median followup was 66 months.
  
  
  RESULTS
  Peak velocity in the aortomesenteric portion, and the anteroposterior diameter ratio of the renal hilum and the aortomesenteric portion of the left renal vein on Duplex ultrasound after stenting was significantly decreased compared to that on Duplex ultrasound before stenting (p<0.05). However, peak velocity in the hilar portion did not statistically differ (p>0.05). Symptoms resolved or improved in 15, 24 and 20 of the 61 patients within 1 week, and 1 and 6 months, respectively, after endovascular stenting. Symptoms remained unchanged in 2 patients and recurred in 1. A perioperative complication was noted in 1 patient, that is a stent that was mistakenly moved and poorly deployed in a left renal vein collateral required operative intervention. Postoperative complications included stent migration into the right atrium, stent protrusion into the inferior vena cava and stent migration into the hilar left renal vein in 1 case each.
  
  
  CONCLUSIONS
  Based on our long-term followup endovascular stenting is a safe, effective procedure in select adults. We recommend endovascular stenting as primary option for nutcracker syndrome.
authors.affiliation: Department of Urology, First Affiliated Hospital of Medical College, Zhejiang University, Hangzhou, People's Republic of China. csw123@sohu.com
authors.forename: Shanwen
authors.initials: S
authors.lastname: Chen
authors.forename: Hongkun
authors.initials: H
authors.lastname: Zhang
authors.forename: Heng
authors.initials: H
authors.lastname: Shi
authors.forename: Lu
authors.initials: L
authors.lastname: Tian
authors.forename: Wei
authors.initials: W
authors.lastname: Jin
authors.forename: Ming
authors.initials: M
authors.lastname: Li
mesh_terms: D000293:Adolescent; D000328:Adult; D001416:Back Pain / Q000601:surgery*; D057510:Endovascular Procedures; D005260:Female; D005500:Follow-Up Studies; D006417:Hematuria / Q000601:surgery*; D006801:Humans; D008297:Male; D008875:Middle Aged; D012082:Renal Veins; D012189:Retrospective Studies; D015607:Stents; D013577:Syndrome; D013997:Time Factors; D055815:Young Adult