Renal nutcracker syndrome: surgical options.
Nutcracker syndrome is one of the abdominal venous entrapments, caused by compression of the left renal vein between the superior mesenteric artery and the abdominal aorta. Occasionally a retro-aortic left renal vein is compressed between the aorta and the vertebral body (posterior nutcracker syndrome). The renal vein distal to the compression is dilated and renal venous flow can be diverted toward the pelvis through an incompetent, refluxing, left ovarian or spermatic vein, in addition to drainage through retroperitoneal venous collaterals. In this article, we describe the different surgical and endovascular techniques that are used to treat this syndrome.
Division of Cardiovascular Surgery, Mayo Clinic, Rochester, MN 55905, USA.
Sameh M
SM
Said
Peter
P
Gloviczki
Manju
M
Kalra
Gustavo S
GS
Oderich
Audra A
AA
Duncan
Mark
M
D Fleming
Thomas C
TC
Bower
D003097:Collateral Circulation; D003251:Constriction, Pathologic; D003952:Diagnostic Imaging / Q000379:methods; D057510:Endovascular Procedures; D006801:Humans; D012079:Renal Circulation; D059228:Renal Nutcracker Syndrome / Q000175:diagnosis / Q000503:physiopathology / Q000601:surgery*; D012082:Renal Veins / Q000503:physiopathology / Q000601:surgery*; D016896:Treatment Outcome; D014656:Vascular Surgical Procedures