Endovascular treatment of nutcracker syndrome

A 23-year-old woman was admitted with progressively worsening left flank pain and recurrent episodes of gross and microscopic hematuria. Routine laboratory investigations were within normal limits. A computed tomography protocol for the evaluation of hematuria revealed a proximal dilatation of the left renal vein and varicosity of the left ovarian vein, with inverted blood flow and the presence of collateral vessels (Figure 1). A diagnosis of anterior nutcracker syndrome was established. Subsequent angiography confirmed the diagnosis, and the patient underwent a successful endovascular stenting procedure, with placement of a self-expanding stent (VENOUS WALLSTENT, 14 mm × 40 mm; Figure 2).