Endovascular treatment of the nutcracker syndrome: report of two cases

  • Nawaphan Taengsakul Department of Surgery, Chulabhorn Hospital, HRH Princess Chulabhorn College of Medical Science, Chulabhorn Royal Academy, Bangkok, Thailand
  • Thatchawit Urasuk Division of Vascular Surgery, Department of Surgery, Phramongkutklao Hospital, Bangkok, Thailand
Keywords: Nutcracker syndrome, Left renal vein compression, Pelvic congestion syndrome, Endovascular treatment

Abstract

Background: Nutcracker syndrome (NCS), also known as left renal vein (LRV) entrapment causing dilatation of gonadal vein. Endovascular treatment has evolved as a potential minimally invasive therapy for relief symptom.

Objective: To present the early result of endovascular treatment in patient with NCS.

Material and Methods:  We report two cases of endovascular treatment for NCS with different clinical manifestation. Both of the patients was diagnosed by CT scan. Endovascular treatment was choosing for both cases and started by measure reno-caval pressure gradient. We used 2 different options, such as ovarian vein embolization only and left renal vein stent only.

Results: The treatment of NCS remains a controversy. Endovascular treatment is alternative treatment and less invasive option but had diversity of decision making. We offered successful treatment options, which relieve symptoms of our patients.

Conclusions: Endovascular approach is an alternative treatment of NCS. There were more evidence of this option and revealed good results. Based on our experience, LRV stenting or ovarian vein embolization were good result for NCS. However, further follow-up will be request for determine durability of this approach

 

 

 

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Author Biographies

Nawaphan Taengsakul, Department of Surgery, Chulabhorn Hospital, HRH Princess Chulabhorn College of Medical Science, Chulabhorn Royal Academy, Bangkok, Thailand

 

 

Thatchawit Urasuk, Division of Vascular Surgery, Department of Surgery, Phramongkutklao Hospital, Bangkok, Thailand

 

 

Published
2021-08-29
How to Cite
Taengsakul, N., & Urasuk, T. (2021). Endovascular treatment of the nutcracker syndrome: report of two cases. Journal of the Association of General Surgeons of Thailand under the Royal of Patronage of HM the King , 6(2), 19-26. Retrieved from https://he02.tci-thaijo.org/index.php/agstjournal/article/view/252389