Endovascular treatment of a patient with nutcracker syndrome and pelvic varices involving anterior and posterior renal veins

Belczak, Sérgio Quilici; Neto, Felipe Coelho; Araújo, Walter Junior Boim de; Karakhanian, Walter Khegan; Karakhanian, Walter Z

doi:10.1016/j.jvscit.2022.01.011

Cited by 2 publications

(1 citation statement)

References 16 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…In addition, a left crossed fused renal ectopia (CFRE), with an L-shaped kidney type, can produce a double nutcracker syndrome, as reported in Pupca et al [ 8 ]. A case of endovascular approach in a 36-year-old woman with flank, pelvic pain, and hematuria was reported; this patient, showing an anterior and three posterior renal veins, was treated with gonadal vein embolization and stenting of the major posterior renal vein [ 9 ].…”

Section: Discussionmentioning

confidence: 99%

Anterior and Posterior Nutcracker Syndrome Combined with May–Thurner Syndrome: First Report of This Unique Case

Tiralongo

Galioto²,

Distefano³

et al. 2023

Diagnostics

View full text Add to dashboard Cite

Background: Anterior nutcracker syndrome is defined as the compression of the left renal vein (LRV) between the superior mesenteric artery (SMA) and the aorta, whereas posterior nutcracker syndrome refers to the compression of the retroaortic LRV between the aorta and the vertebral column—the presence of the circumaortic left renal vein may predispose to “combined nutcracker syndrome”. May–Thurner syndrome consists of obstruction of the left common iliac vein caused by the crossing right common iliac artery. We report a unique case of combined nutcracker syndrome associated with May–Thurner syndrome. Case presentation: A 39-year-old Caucasian female came to our radiology unit for triple-negative breast cancer computed tomography (CT) staging. She complained of pain in hermid-back and low-back regions and intermittent abdominal pain in the left flank region. Multidetector computed tomography (MDCT) incidentally revealed a circumaortic left renal vein draining to the inferior vena cava, with bulbous dilatation of both the antero-superior and posterior-inferior branches, which was associated with pathological serpiginous dilation of the left ovarian vein with varicose pelvic veins. Axial CT imaging of the pelvis also showed compression of the left common iliac vein by the overlying right common iliac artery consistent with May–Thurner syndrome without signs of venous thrombosis. Conclusion: Contrast-enhanced CT is the best imaging modality for suspected vascular compression syndromes. CT findings showed a combination of anterior and posterior nutcracker syndrome in the left circumaortic renal vein, associated with May–Thurner syndrome, which has not previously been described in the literature.

show abstract

Section: Discussionmentioning

confidence: 99%