title: Nutcracker syndrome--how well do we know it?
abstract: Nutcracker syndrome (NCS), which is caused by compression of the left renal vein between the abdominal aorta and the superior mesenteric artery, leads to a series of clinical symptoms including hematuria, proteinuria, flank pain, and varicocele. The diagnosis of NCS is difficult due to variations in normal anatomy. Treatment, which ranges from observation to nephrectomy, remains controversial. We conducted a review based on the related literature and our experience with hundreds of cases. We summarize the characteristics of NCS, the different measurements used in diagnosis, and the current treatment options. We present our diagnostic criteria and recommend endovascular stenting as the primary option for NCS.
authors.affiliation: Department of Vascular Surgery, First Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, People's Republic of China.
authors.forename: Yangyan
authors.initials: Y
authors.lastname: He
authors.affiliation: Department of Vascular Surgery, First Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, People's Republic of China.
authors.forename: Ziheng
authors.initials: Z
authors.lastname: Wu
authors.affiliation: Department of Urology, First Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, People's Republic of China.
authors.forename: Shanwen
authors.initials: S
authors.lastname: Chen
authors.affiliation: Department of Vascular Surgery, First Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, People's Republic of China.
authors.forename: Lu
authors.initials: L
authors.lastname: Tian
authors.affiliation: Department of Vascular Surgery, First Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, People's Republic of China.
authors.forename: Donglin
authors.initials: D
authors.lastname: Li
authors.affiliation: Department of Vascular Surgery, First Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, People's Republic of China.
authors.forename: Ming
authors.initials: M
authors.lastname: Li
authors.affiliation: Department of Vascular Surgery, First Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, People's Republic of China.
authors.forename: Wei
authors.initials: W
authors.lastname: Jin
authors.affiliation: Department of Vascular Surgery, First Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, People's Republic of China. Electronic address: heyangyan19881022@163.com.
authors.forename: Hongkun
authors.initials: H
authors.lastname: Zhang
mesh_terms: D003663:Decision Trees; D006801:Humans; D017410:Practice Guidelines as Topic; D059228:Renal Nutcracker Syndrome / Q000175:diagnosis / Q000628:therapy