Use of the Wrapsody™ Cell-Impermeable Endoprosthesis for the treatment of pelvic congestion syndrome due to nutcracker syndrome.

Abstract

Endovascular stenting is a preferred treatment approach for the management of pelvic congestion syndrome (PCS) secondary to nutcracker syndrome. However, there is no consensus on which stenting device is advantageous for patients. In this report, we summarize off-label use of the Wrapsody™ Cell-Impermeable Endoprosthesis (CIE) for this condition. A 30-year-old woman presented with chronic left flank and lower abdominal pain, progressively worsening since childbirth. Imaging demonstrated compression of the left renal vein between the aorta and superior mesenteric artery with reflux into the ovarian vein. Endovascular treatment was performed using a 14 × 40 mm CIE. The procedure was technically successful and symptomatic resolution was achieved without complications. Follow-up over 2 years confirmed persistent device patency and absence of venous congestion. This case highlights that the CIE, a device originally designed for restoration of hemodialysis access, is an effective endovascular option for managing PCS due to nutcracker syndrome.