Left renocaval venous bypass with autologous great saphenous vein for nutcracker syndrome.

Abstract

Nutcracker syndrome results from left renal vein compression by the abdominal aorta and the superior mesenteric artery. The consecutively increased renal venous pressure results in hematuria, proteinuria, flank pain, left-sided varicocele, pelvic congestion, and others. We report a 25-year-old man with nutcracker syndrome who underwent successful left renocaval venous bypass with autologous great saphenous vein. The patient's condition clearly improved, with no clinical relapse after treatment. Ultrasound imaging showed patency of the venous bypass and decreased venous hypertension. This technique is a feasible choice for surgical treatment of nutcracker syndrome, with a low incidence of complications and satisfactory results.