Outcomes of left renal vein stenting in patients with nutcracker syndrome.

摘要: Abstract Background Nutcracker syndrome (NCS) is a rare condition that can be manifested with hematuria, flank pain, pelvic varicosities, or chronic congestion related to left renal vein (LRV) compression. Open surgery, specifically LRV transposition, has been the mainstay of treatment, but in past few years, stenting emerged as less invasive alternative without sufficient evidence support it. This study aimed assess outcomes treatment NCS. Methods A retrospective chart review patients NCS who underwent between 2010 and 2018 was performed. End points were perioperative adverse outcomes, symptom relief, stent patency. Symptom resolution classified complete, partial, none on basis interpretation medical records clinical follow-up. Standard descriptive statistics survival analysis used. Results Eighteen (17 female; mean age, 38.1 ± 16.9 years) diagnosed treated identified. Five these had prior transposition failed within 7.0 ± 4.9 months, by recurrence (or no improvement) along imaging persistently severe stenosis. Twelve coexisting gonadal embolization. The most frequent sign hematuria (10/18 patients) pain (15/18 patients), respectively. All received self-expanding stents (mean diameter, 12.8 ± 1.6 mm), smaller ones typically placed previously transposed LRVs. No complications occurred. Nine discharged same day; remaining stayed longer for control hospital stay, 1.0 ± 1.3 days). At an average follow-up 41.4 ± 26.6 months, 13 (72.2%) symptoms resolved improved (9 4 partial). Three five whose remained unchanged previous two three eventually required autotransplantation. Six 10 presented it resolved. reintervention at 5.8 months, 16.8 months, 51.7 months because restenosis. early balloon venoplasty third one restenting. Two-year primary assisted patency 85.2% 100%, migration Conclusions Endovascular safe, providing encouraging results good midterm rates relief. Minimally approaches may have potential role Larger series are needed better comparative performance against transposition.