title: Renal vein stenting via the right internal jugular approach with a provocative Valsalva maneuver to reduce the risk of stent migration.
abstract: An adult male with nutcracker syndrome was treated successfully by placement of a self-expanding stent in the left renal vein via a right internal jugular vein approach with a provocative Valsalva maneuver. Previous case reports have described renal vein stenting for this condition via common femoral vein approach. However, this study proposes the right internal jugular vein approach as a safer method for the treatment of nutcracker syndrome since the stent can be easily captured along the guidewire if undersized. This technique is based on the realization that the left renal vein diameter may increase by 50% to 58% during the Valsalva maneuver.
authors.affiliation: Dayton Interventional Radiology, Dayton, OH, USA. mubinsyed@aol.com
authors.forename: Mubin I
authors.initials: MI
authors.lastname: Syed
authors.forename: Benjamin
authors.initials: B
authors.lastname: Yu
authors.forename: Talal
authors.initials: T
authors.lastname: Akhter
authors.forename: Azim
authors.initials: A
authors.lastname: Shaikh
mesh_terms: D000328:Adult; D003251:Constriction, Pathologic; D057510:Endovascular Procedures / Q000009:adverse effects / Q000295:instrumentation*; D005548:Foreign-Body Migration / Q000209:etiology / Q000517:prevention & control*; D006801:Humans; D007601:Jugular Veins; D008297:Male; D010690:Phlebography; D059228:Renal Nutcracker Syndrome / Q000000981:diagnostic imaging / Q000628:therapy*; D012082:Renal Veins / Q000000981:diagnostic imaging; D015607:Stents; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome; D014636:Valsalva Maneuver