Quevedo Henry C, Arain Salman A, Abi Rafeh Nidal
Tulane University, Heart and Vascular Institute, New Orleans, LA 70112.
Tulane University, Heart and Vascular Institute, New Orleans, LA 70112.
Cardiovasc Revasc Med. 2014 Jul-Aug;15(5):305-7. doi: 10.1016/j.carrev.2014.04.008. Epub 2014 Apr 26.
The left renal vein (LRV) entrapment syndrome is a rare condition. Here, we present a 22-year-old female presenting with recurrent nausea, vomiting, weight loss and evidence of the LRV compression by the superior mesenteric artery and the abdominal aorta. Hemodynamic assessment confirmed a pressure gradient of >3 mmHg between the LRV and the inferior vena cava. A self-expandable stent was then deployed in the LRV. Subsequent clinical follow-ups ensure full resolution of the patient's symptoms.
Multilingual search was performed in PubMed, Google scholar, Scielo, Korea Med and EMBASE with the medical subheadings "nutcracker syndrome", "nutcracker phenomenon" and "compression vein syndrome" from January 1983 to September 2013.
Review of the literature exhibited a plethora of individual case reports (291 citations). Importantly, few retrospective case series [5] comprising a total of 157 patients included successful endovascular interventions.
Endovascular therapy for nutcracker syndrome represents a safe and suitable treatment option, but prospective studies are needed to confirm these data.
左肾静脉受压综合征是一种罕见疾病。在此，我们报告一名22岁女性，出现反复恶心、呕吐、体重减轻，并有肠系膜上动脉和腹主动脉压迫左肾静脉的证据。血流动力学评估证实左肾静脉与下腔静脉之间的压力梯度>3 mmHg。随后在左肾静脉置入了自膨式支架。后续的临床随访证实患者症状完全缓解。
于1983年1月至2013年9月期间，在PubMed、谷歌学术、Scielo、韩国医学数据库和EMBASE中使用医学副标题“胡桃夹综合征”“胡桃夹现象”和“静脉受压综合征”进行多语言检索。
文献回顾显示有大量的个案报告（291条引用）。重要的是，仅有少数回顾性病例系列研究[5]，共纳入157例患者，其中包括成功的血管内介入治疗。
胡桃夹综合征的血管内治疗是一种安全且合适的治疗选择，但需要前瞻性研究来证实这些数据。
