title: A therapeutic option in nutcracker syndrome and ovarian vein insufficiency.
abstract: OBJECTIVE
  The nutcracker syndrome (NS) may lead to insufficient perirenal collaterals as well as incompetence of the left ovarian vein with consecutive ovarian vein insufficiency.
  
  
  METHODS
  A female patient with NS and severe genital varicosis was treated with dilation of the renal vein and coiling of a left perirenal collateral vein feeding an insufficient left ovarian vein (LOV) with pelvic vein varicosity.
  
  
  RESULTS
  In re-evaluation 18 month later with left renal vein (LRV) and LOV phlebography, a widely patent LRV was found. The embolized LRV to LOV collateral was occluded. However, left hypogastric phlebography showed incompetent branches of the left hypogastric vein feeding the genital varicose veins. These were successfully embolized with coils and the genital varicosity decreased on follow-up.
  
  
  CONCLUSIONS
  In our patient a combined therapeutic approach with balloon dilation of the NS and embolization of the genital varicose veins by left hypogastric vein coil was performed.
authors: Vein Clinic Bellevue, 8280 Kreuzlingen, Switzerland.
authors: V
authors: V
authors: Bekou
authors: C
authors: C
authors: Zollikofer
authors: N
authors: N
authors: Nieuwkamp
authors: A
authors: A
authors: von Weymarn
authors: S
authors: S
authors: Duewell
authors: J
authors: J
authors: Traber
mesh_terms: D005260:Female; D006801:Humans; D008875:Middle Aged; D010049:Ovarian Diseases / Q000150:complications / Q000473:pathology / Q000628:therapy*; D059228:Renal Nutcracker Syndrome / Q000150:complications / Q000473:pathology / Q000628:therapy*; D012082:Renal Veins / Q000473:pathology; D014689:Venous Insufficiency / Q000150:complications / Q000473:pathology / Q000628:therapy*; D014845:Vulvar Diseases / Q000150:complications / Q000473:pathology / Q000628:therapy*
keywords: left ovarian vein; left renal vein; nutcracker syndrome; ovarian vein insufficiency; pelvic congestion syndrome; pressure measurement; renal hypertension; stenting