Tratamento endovascular da síndrome de quebra-nozes: relato de caso

Agle, Claudia Guimarães; Filho, Dejean Sampaio Amorim; Almeida, Leonardo Cortizo de; Neves, Cesar Amorim Pacheco

doi:10.1590/1677-5449.180135

Cited by 4 publications

(2 citation statements)

References 16 publications

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“…Conservative treatment, of choice, when possible, consists in restoring the normal layer of peri-vascular fat tissue with a high calorie diet [ 34 ]. The other two therapeutic approaches are surgical treatment [ 35 , 36 ] and endovascular stenting treatment [ 37 ]. The surgical treatment consists in overcoming the stenosis with the resection of the first jejunal loop and the retrovascular duodenum followed by the anastomosis between the duodenum and the second jejunal loop which are anteriorized.…”

Section: Nutcracker Syndrome (Ncs)mentioning

confidence: 99%

The role of ultrasound imaging in vascular compression syndromes

Farina¹,

Foti²,

Conti³

et al. 2021

Ultrasound J

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Vascular compression syndromes are rare alterations that have in common the compression of an arterial and/or venous vessel by contiguous structures and can be congenital or acquired. The best known are the Thoracic Outlet Syndrome, Nutcracker Syndrome, May–Thurner Syndrome, and Dunbar Syndrome. The incidence of these pathologies is certainly underestimated due to the non-specific clinical signs and their frequent asymptomaticity. Being a first-level method, Ultrasound plays a very important role in identifying these alterations, almost always allowing a complete diagnostic classification. If in expert hands, this method can significantly contribute to the reduction of false negatives, especially in the asymptomatic population, where the finding of the aforementioned pathologies often happens randomly following routine checks. In this review, we briefly discuss the best known vascular changes, the corresponding ultrasound anatomy, and typical ultrasound patterns.

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Section: Nutcracker Syndrome (Ncs)mentioning

confidence: 99%

The role of ultrasound imaging in vascular compression syndromes

Farina¹,

Foti²,

Conti³

et al. 2021

Ultrasound J

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“…На сегодняшний день в доступной литературе, касающейся вопросов стентирования ЛПВ, имеются свидетельства малого опыта (суммарно не более 150) [42], преимущественно в формате «клинический случай». Мы предлагаем к обсуждению наш личный опыт эндоваскулярного лечения 35 пациентов с синдромом орехокола.…”

Section: Introductionunclassified

Left renal vein stenting: indications, disputable points, immediate and long-term results

Васильев

Жуков²,

Синицын

et al. 2021

Androl. genit. hir.

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The article presents the results of stenting of the left renal vein in 35 patients with proven hemodynamically significant compression of the vein in “aorto-mesenteric tweezers”. Clinical manifestations of lesions of the left renal vein are very diverse, and pathogenetic mechanisms remain not fully understood. Therefore, the determination of indications for stenting and perfect technical performance are predictors of success in the near and long-term periods of postoperative follow-up. Our experience in stenting the left renal vein demonstrates the possibility of achieving intraoperative technical success in 100 % of cases, as well as a significant improvement in the quality of life in most patients after endovascular intervention, due to a significant reduction in the clinical manifestations of the pathological phenomenon.

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Successful Resolution of Nutcracker Syndrome with 3D Printed PEEK Extravascular Stent in an Adolescent Boy

Da-li¹

2022

acc

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Three-dimensional printed polyetheretherketone (PEEK) extravascular stent was applied to treat a 14-year-old boy with nutcracker syndrome. Digital subtraction angiography revealed a segment of the left renal vein (LRV) with reduced contrast filling immediately before its inflow into the inferior vena cava, and high-pressure gradient. The three-dimensional reconstruction model demonstrated that the LRV and the duodenum were contracted at the aortomesenteric angle, resulting in LRV compression from the abnormal high-level duodenal compartment. When duodenum courses between the abdominal aorta and superior mesenteric artery (duodenal interposition), the LRV entrapment occurs even at <90 aortomesenteric degrees. Three-dimensional printed PEEK extravascular stent was chosen to elevate the superior mesenteric artery and lower the duodenum position, thus relieving LRV compression. This extravascular application has significant advantages over open surgery, endovascular stenting and artificial vessel procedures with expanded polytetrafluoroethylene. It provides better cellular vitality by ensuring soft tissue proliferation. By reducing external acceleration and centrifugal force, a three-dimensional printed PEEK extravascular stent reduces adverse side effects. Such a stent has a distinctive personalized design, good stiffness, and durability that allows blood vessel growth, preventing stent migration and thrombosis. Therefore, it is suitable for both adult and pediatric patients. According to the abdominal ultrasound and multi-slice computed tomography scan, the postoperative follow-up results were satisfactory one year after surgery. The patient felt well, the blood flow in the LRV was not obstructed, and the blood flow velocity was average. The external stent was in place.

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Tratamento endovascular da síndrome de quebra-nozes: relato de caso

Cited by 4 publications

References 16 publications

The role of ultrasound imaging in vascular compression syndromes

The role of ultrasound imaging in vascular compression syndromes

Left renal vein stenting: indications, disputable points, immediate and long-term results

Successful Resolution of Nutcracker Syndrome with 3D Printed PEEK Extravascular Stent in an Adolescent Boy

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