title: Extravascular stent management for migration of left renal vein endovascular stent in nutcracker syndrome.
abstract: BACKGROUND
  Nutcracker syndrome is an entity resulting from left renal vein compression by the aorta and the superior mesenteric artery, which leads to symptoms of hematuria or left flank pain. The alternative option of endovascular or extravascular stenting is very appealing because of the minimal invasive procedures. Stents in the renal vein can cause fibromuscular hyperplasia, proximal migration or embolization.
  
  
  METHODS
  A 30-year-old female was diagnosed with nutcracker syndrome for severe left flank pain. After failed conservative approach, she underwent endovascular stenting and subsequently developed recurrent symptom for stent migration one month postoperatively. She underwent successful extravascular stenting with complete symptom resolution.
  
  
  CONCLUSIONS
  The extravascular stenting is an alternative option after migration of left renal vein endovascular stenting. The computed tomographic imaging was closely correlated to therapeutic interventions and stent migration.
authors.affiliation: Department of Vascular Surgery, the First Affiliated Hospital of Medical College, Zhejiang University, Hangzhou, 310003, China. d-niro@163.com.
authors.forename: Lu
authors.initials: L
authors.lastname: Tian
authors.affiliation: Department of Urology, the First Affiliated Hospital of Medical College, Zhejiang University, No. 79 Qing Chun Road, HangZhou, 310003, China. chensw123@126.com.
authors.forename: Shanwen
authors.initials: S
authors.lastname: Chen
authors.affiliation: Department of Urology, the Second Affiliated Hospital of Zhejiang Chinese Medical University, Hangzhou, 310005, China. zhanggaoyue1122@163.com.
authors.forename: Gaoyue
authors.initials: G
authors.lastname: Zhang
authors.affiliation: Department of Vascular Surgery, the First Affiliated Hospital of Medical College, Zhejiang University, Hangzhou, 310003, China. csw123@sohu.com.
authors.forename: Hongkun
authors.initials: H
authors.lastname: Zhang
authors.affiliation: Department of Vascular Surgery, the First Affiliated Hospital of Medical College, Zhejiang University, Hangzhou, 310003, China. urology123@aliyun.com.
authors.forename: Wei
authors.initials: W
authors.lastname: Jin
authors.affiliation: Department of Vascular Surgery, the First Affiliated Hospital of Medical College, Zhejiang University, Hangzhou, 310003, China. urology123@hotmail.com.
authors.forename: Ming
authors.initials: M
authors.lastname: Li
mesh_terms: D000328:Adult; D001807:Blood Vessel Prosthesis / Q000009:adverse effects*; D005260:Female; D005548:Foreign-Body Migration / Q000000981:diagnostic imaging / Q000209:etiology* / Q000601:surgery*; D006801:Humans; D011859:Radiography; D059228:Renal Nutcracker Syndrome / Q000000981:diagnostic imaging / Q000601:surgery*; D012086:Reoperation; D015607:Stents / Q000009:adverse effects*; D016896:Treatment Outcome