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Case report
Endovascular treatment of anterior nutcracker syndrome and pelvic varices in a patient with an anterior and a posterior renal vein
  1. Sergio Quilici Belczak1,
  2. Felipe Coelho Neto2,
  3. Walter Junior Boim de Araújo3 and
  4. José Maria de Pereira Godoy4
  1. 1IAPACE - Instituto de Aprimoramento e Pesquisa em Angiorradiologia e Cirurgia Endovascular, São Paulo, Brazil
  2. 2Pontifícia Universidade Católica do Paraná, Curitiba, PR, Brazil
  3. 3Universidade Federal do Paraná, Curitiba, PR, Brazil
  4. 4Faculdade de Medicina de São José do Rio Preto, Sao Jose do Rio Preto, SP, Brazil
  1. Correspondence to Dr Sergio Quilici Belczak; belczak{at}gmail.com

Abstract

There are few data on endovascular treatment of anterior nutcracker syndrome and pelvic varices in patients with anterior and posterior renal veins. Our objective is to report a case, identify occurrences and compare diagnosis and treatments. A 42-year-old woman presented with flank and pelvic pain and hematuria. She had anterior nutcracker syndrome and pelvic varices with an anterior and a posterior renal vein. A successful complete endovascular approach was done with stent implantation in the anterior renal vein and left gonadal vein embolisation. After 12-month follow-up, the patient remained asymptomatic with good results on CT. Only two case reports of patients with nutcracker syndrome with anterior and posterior renal veins were identified. In both, a self-expanding stent was implanted in the anterior renal vein. In conclusion, endovascular treatment represents a safe and successful option in patients with nutcracker syndrome and pelvic varices with an anterior and a posterior renal vein.

  • cardiovascular system
  • varices

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Footnotes

  • Contributors SB: conception and design, data collection, writing the article, critical revision of the article. SB, JMPG: analysis and interpretation. SB, JMPG, FCN, WJBA: final approval of the article. SB, FCN: statistical analysis. SB, WJBA: overall responsibility. All authors have read and approved the final version of the article.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Patient consent for publication Obtained.

  • Provenance and peer review Not commissioned; externally peer reviewed.