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Treatment of Nutcracker Syndrome

The human body is symmetrical for the most part. However, the aorta is located just to the left of midline and the vena cava is just to the right. As a result the superior mesenteric artery lies just over the left renal vein. In some people, the left renal vein can become wedged between the abdominal aorta and the superior mesenteric artery. The name “nutcracker syndrome” comes from the image of the left renal vein being compressed, or “cracked,” between the aorta and superior mesenteric arteries. Symptoms of Nutcracker Syndrome include hematuria (blood in the urine), left flank pain, left lower quadrant pain in women and left testicular swelling or pain in men.

If Nutcracker Syndrome is suspected, there are several tests that are run to both support and confirm the diagnosis. First, the urine will be tested to demonstrate microscopic blood in the urine if it is not visually obvious. An ultrasound of the blood vessels will demonstrate compression of the vein. However, diagnosis is confirmed with computed tomography angiography (CTA). This test also demonstrates anatomy and allows the surgeon to determine the most ideal treatment. Currently, many patients are treated with endovascular stenting. In these cases, a metal stent is placed in the area compressed by the superior mesenteric artery. In the recent past, open bypass was performed. Depending on the anatomy and the health of the patient, an open bypass may still be the best choice. Your vascular surgeon will discuss treatment options for your particular anatomy and their risks and benefits so you can make an informed decision.

If patients are suffering from Nutcracker Syndrome, it is important that they locate an acquainted vascular surgeon to carry out the treatment of Nutcracker Syndrome. Dr. Jenna Kazil is a skilled expert vascular surgeon in Bradenton, FL, who sees West Florida patients from Sarasota to Tampa at various hospitals. Dr. Kazil understands the complexities of Nutcracker Syndrome and has the experience necessary to deftly carry out the challenging procedure. Patients in need of a proficient vascular surgeon should contact Dr. Kazil at the Florida Surgical Clinic for their surgical and vascular needs.


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