Role of intravascular ultrasound in endovascular management of nutcracker syndrome: A case report.

IF 1 4区医学 Q4 PERIPHERAL VASCULAR DISEASE

Vascular Pub Date : 2024-12-01 Epub Date: 2023-08-03 DOI:10.1177/17085381231192682

Emma K Satchell, Sri H Senapathi, Umashankar K Ballehaninna

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引用次数: 0

Abstract

Purpose: Here, we describe nutcracker syndrome management using intravascular ultrasound (IVUS) during endovascular stent placement of the renal vein.

Case report: A 60-year-old woman with a known Factor V Leiden mutation, long-standing smoking history, and family history of pancreatic cancer presented with 2 years of intermittent left upper quadrant pain (LUQ) and a 15 lb unintentional weight loss. Work-up included abdominal ultrasound (US) and abdominal computerized tomography (CT) scan. Abdominal US and Chest CT scan were negative while the abdominal CT scan revealed severe compression of the left renal vein by the superior mesenteric artery, consistent with nutcracker syndrome. Renal venogram and endovascular stent placement performed under IVUS guidance. IVUS was used to determine stent size and measure flow and assess patency after stent placement.

Conclusions: Post-renal vein stent placement, the patient had resolution of her symptoms with follow-up duplex renal ultrasound exam demonstrating restored blood flow in the left renal vein with improved patency.

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血管内超声在胡桃夹综合征血管内治疗中的作用：病例报告。

目的：在此，我们介绍了在肾静脉血管内支架置入过程中使用血管内超声（IVUS）治疗胡桃夹综合征的方法：一名 60 岁女性，已知因子 V Leiden 突变、长期吸烟史和胰腺癌家族史，因间歇性左上腹疼痛（LUQ）2 年和体重意外下降 15 磅就诊。检查包括腹部超声波（US）和腹部计算机断层扫描（CT）。腹部 US 和胸部 CT 扫描结果均为阴性，而腹部 CT 扫描显示左肾静脉受到肠系膜上动脉的严重压迫，与胡桃钳综合征一致。在血管内超声引导下进行了肾静脉造影和血管内支架置入术。IVUS用于确定支架尺寸、测量血流和评估支架置入后的通畅性：肾静脉支架置入术后，患者的症状得到缓解，随访的双相肾超声检查显示左肾静脉血流恢复，通畅性得到改善。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Vascular 医学-外周血管病

CiteScore

2.30

自引率

9.10%

发文量

196

审稿时长

6-12 weeks

期刊介绍： Vascular provides readers with new and unusual up-to-date articles and case reports focusing on vascular and endovascular topics. It is a highly international forum for the discussion and debate of all aspects of this distinct surgical specialty. It also features opinion pieces, literature reviews and controversial issues presented from various points of view.