Correlation between “Nutcracker phenomenon” and venous hypertension of the lower extremities: Three case reports

We report three cases of left renal vein (LRV) compression resulting in deep venous insufficiency of the lower extremities, among which two patients showed clinical symptoms in both lower extremities. All patients were treated successfully with LRV stenting. The pathophysiology suggested that the se...

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Bibliographic Details
Published in:Journal of vascular surgery cases and innovative techniques 2022-12, Vol.8 (4), p.802-806
Main Authors: Hoshino, Yuji, Yokoi, Hiroyoshi
Format: Article
Language:English
Subjects:
Case report
Deep venous insufficiency
Gonadal vein reflux
Nutcracker phenomenon
Pelvic venous disorders
Renal vein compression
Renal vein stenting
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Summary:We report three cases of left renal vein (LRV) compression resulting in deep venous insufficiency of the lower extremities, among which two patients showed clinical symptoms in both lower extremities. All patients were treated successfully with LRV stenting. The pathophysiology suggested that the secondary gonadal vein reflux owing to LRV compression drained into the iliac veins, resulting in a volume overload and venous hypertension in the iliocaval region. Computed tomography angiography was useful in diagnosing this condition, allowing the evaluation of LRV compression, identification of early opacification of the gonadal vein reflux, and exclusion of other pathologies resulting in deep venous insufficiency of the lower extremities.
ISSN:2468-4287
2468-4287
DOI:10.1016/j.jvscit.2022.10.016