Hinojosa Carlos A, Anaya-Ayala Javier E, Boyer-Duck Estefanía, Laparra-Escareno Hugo, Torres-Machorro Adriana, Lizola Rene
Sección de Angiología, Cirugía Vascular y Terapia Endovascular, Dirección de Cirugía, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Ciudad de México, México.
Sección de Angiología, Cirugía Vascular y Terapia Endovascular, Dirección de Cirugía, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Ciudad de México, México.
Cir Cir. 2017 Dec;85 Suppl 1:19-25. doi: 10.1016/j.circir.2016.11.015. Epub 2016 Dec 28.
Nutcracker syndrome is a rare entity, and in the majority of cases is the result of extrinsic compression of the left renal vein between the superior mesenteric artery and the aorta, associated with functional stenosis.
To present the case of a 19-year-old female with no significant medical history with confirmed diagnosed of nutcracker syndrome treated successfully by endovascular means.
She was referred to the Vascular Surgery Department with a 6-month history of macroscopic haematuria, after other aetiologies were ruled out. Abdominal computed tomography angiography revealed compression of the left renal vein; the patient underwent endovascular treatment, and a 12×16 mm balloon expandable stent was placed with immediate angiographic improvement, decreased pressure gradients and progressive resolution of haematuria. At one year, she remains symptom-free.
Nutcracker syndrome is uncommon, and a high index of suspicion is needed. Macroscopic haematuria is not always present, and in our case stent placement demonstrated effectiveness in the resolution of symptoms at 12 months' follow--up. We also present a brief review of the literature.
胡桃夹综合征是一种罕见疾病，在大多数情况下是由于肠系膜上动脉与腹主动脉之间对左肾静脉的外在压迫，并伴有功能性狭窄所致。
介绍一名19岁无重大病史且确诊为胡桃夹综合征的女性患者，通过血管内治疗成功治愈的病例。
在排除其他病因后，该患者因6个月肉眼血尿病史被转诊至血管外科。腹部计算机断层扫描血管造影显示左肾静脉受压；患者接受了血管内治疗，置入了一枚12×16毫米的球囊扩张支架，血管造影立即改善，压力梯度降低，血尿逐渐消退。一年后，她仍无症状。
胡桃夹综合征并不常见，需要高度怀疑。并非总是出现肉眼血尿，在我们的病例中，支架置入在12个月的随访中显示出对症状缓解有效。我们还对文献进行了简要综述。
