title: [Macroscopic hematuria secondary to nutcracker syndrome and successful endovascular treatment].
abstract: BACKGROUND
  Nutcracker syndrome is a rare entity, and in the majority of cases is the result of extrinsic compression of the left renal vein between the superior mesenteric artery and the aorta, associated with functional stenosis.
  
  
  OBJECTIVE
  To present the case of a 19-year-old female with no significant medical history with confirmed diagnosed of nutcracker syndrome treated successfully by endovascular means.
  
  
  METHODS
  She was referred to the Vascular Surgery Department with a 6-month history of macroscopic haematuria, after other aetiologies were ruled out. Abdominal computed tomography angiography revealed compression of the left renal vein; the patient underwent endovascular treatment, and a 12×16 mm balloon expandable stent was placed with immediate angiographic improvement, decreased pressure gradients and progressive resolution of haematuria. At one year, she remains symptom-free.
  
  
  CONCLUSIONS
  Nutcracker syndrome is uncommon, and a high index of suspicion is needed. Macroscopic haematuria is not always present, and in our case stent placement demonstrated effectiveness in the resolution of symptoms at 12 months' follow--up. We also present a brief review of the literature.
authors.affiliation: Sección de Angiología, Cirugía Vascular y Terapia Endovascular, Dirección de Cirugía, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Ciudad de México, México. Electronic address: carlos.a.hinojosa@gmail.com.
authors.forename: Carlos A
authors.initials: CA
authors.lastname: Hinojosa
authors.affiliation: Sección de Angiología, Cirugía Vascular y Terapia Endovascular, Dirección de Cirugía, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Ciudad de México, México.
authors.forename: Javier E
authors.initials: JE
authors.lastname: Anaya-Ayala
authors.affiliation: Sección de Angiología, Cirugía Vascular y Terapia Endovascular, Dirección de Cirugía, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Ciudad de México, México.
authors.forename: Estefanía
authors.initials: E
authors.lastname: Boyer-Duck
authors.affiliation: Sección de Angiología, Cirugía Vascular y Terapia Endovascular, Dirección de Cirugía, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Ciudad de México, México.
authors.forename: Hugo
authors.initials: H
authors.lastname: Laparra-Escareno
authors.affiliation: Sección de Angiología, Cirugía Vascular y Terapia Endovascular, Dirección de Cirugía, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Ciudad de México, México.
authors.forename: Adriana
authors.initials: A
authors.lastname: Torres-Machorro
authors.affiliation: Sección de Angiología, Cirugía Vascular y Terapia Endovascular, Dirección de Cirugía, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Ciudad de México, México.
authors.forename: Rene
authors.initials: R
authors.lastname: Lizola
mesh_terms: D057510:Endovascular Procedures / Q000379:methods*; D005260:Female; D006417:Hematuria / Q000209:etiology*; D006801:Humans; D059228:Renal Nutcracker Syndrome / Q000150:complications / Q000601:surgery*; D012082:Renal Veins / Q000503:physiopathology; D015607:Stents; D014690:Venous Pressure; D055815:Young Adult
keywords: Colocación de stent; Endovascular treatment; Haematuria; Hematuria; Nutcracker syndrome; Stent placement; Síndrome de cascanueces; Tratamiento endovascular