Xiaobai Wang, MD, Yan Zhang, MD, Chengzhi Li, MD, Hong Zhang, MD

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Presentation transcript:

Results of endovascular treatment for patients with nutcracker syndrome Xiaobai Wang, MD, Yan Zhang, MD, Chengzhi Li, MD, Hong Zhang, MD Journal of Vascular Surgery Volume 56, Issue 1, Pages 142-148 (July 2012) DOI: 10.1016/j.jvs.2012.01.007 Copyright © 2012 Society for Vascular Surgery Terms and Conditions

Fig 1 Selective left renal phlebography demonstrating severe stenosis of the pre-aortic segment of the left renal vein (LRV) with a compression in nutcracker syndrome (NCS) patients. Journal of Vascular Surgery 2012 56, 142-148DOI: (10.1016/j.jvs.2012.01.007) Copyright © 2012 Society for Vascular Surgery Terms and Conditions

Fig 2 Selective left renal phlebography in another nutcracker syndrome (NCS) patient showed stenosis of the left renal vein (LRV) with dye stagnation and large collateral pathways (left gonadic vein) (arrow) (A). There was massive reflux in the left gonadic vein (arrow) (B). Metallic coil embolization was performed in the proximal left gonadic vein in the patient and repeated venography of the LRV showed the occlusion of the gonadal vein, and the massive reflux disappeared (C). Completion venography within the stent before the sheath was retrieved, showing the stenosis of the LRV was relieved. To achieve good fixation, the distal (left) end of the stent was deployed in the first large branch of the LRV. Therefore, the left end of the stent appears to be stenosed at <50% of the diameter of the remaining portion of the stent (D). Journal of Vascular Surgery 2012 56, 142-148DOI: (10.1016/j.jvs.2012.01.007) Copyright © 2012 Society for Vascular Surgery Terms and Conditions

Fig 3 Ultrasonography (A and B), computed tomography (CT) (C), and magnetic resonance imaging (D) revealed the entrapment of the left renal vein (LRV) (blue arrows) between the superior mesenteric artery and aorta clearly. CT angiography and magnetic resonance angiography also showed the dilatation of the LRV. Journal of Vascular Surgery 2012 56, 142-148DOI: (10.1016/j.jvs.2012.01.007) Copyright © 2012 Society for Vascular Surgery Terms and Conditions

Fig 4 Compared with the plain abdominal radiograph immediately after the operation (A), the stent was significantly migrated to the right at 12 months after the operation (B). Journal of Vascular Surgery 2012 56, 142-148DOI: (10.1016/j.jvs.2012.01.007) Copyright © 2012 Society for Vascular Surgery Terms and Conditions