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CC BY-NC-ND 4.0 · Journal of Clinical Interventional Radiology ISVIR 2018; 02(03): 197-200
DOI: 10.1055/s-0038-1675864
Case Report
Indian Society of Vascular and Interventional Radiology

Aortomegaly Causing Nutcracker Syndrome and Pelvic Congestion Syndrome

Krantikumar Rathod
1   Department of Radiology, Seth G.S. Medical College & KEM Hospital, Parel, Mumbai, Maharashtra, India
,
Amit Sahu
1   Department of Radiology, Seth G.S. Medical College & KEM Hospital, Parel, Mumbai, Maharashtra, India
,
Bhavesh Popat
1   Department of Radiology, Seth G.S. Medical College & KEM Hospital, Parel, Mumbai, Maharashtra, India
,
Hemant Deshmukh
1   Department of Radiology, Seth G.S. Medical College & KEM Hospital, Parel, Mumbai, Maharashtra, India
› Author Affiliations Funding None.
Further Information

Publication History

Received: 10 July 2018

Accepted after revision: 18 July 2018

Publication Date:
27 November 2018 (online)

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Abstract

The authors present an uncommon cause of pelvic congestion syndrome (PCS) secondary to anterior nutcracker syndrome, which was caused by aortomegaly. Positional flank and pelvic pain was the only presenting feature with no renal dysfunction. Early and significant decompression of left renal vein (LRV) via left ovarian vein resulted in preserved renal function with symptomatic pelvic varices. Endovascular management by left ovarian vein coiling and LRV stenting was done. They briefly review the etiopathology, imaging, treatment rationale, and management options for nutcracker and PCS.

Keywords

pelvic congestion syndrome - nutcracker syndrome - ovarian vein embolization - renal vein stenting - aortomegaly
 

  • References

  • 1 Durham JD, Machan L. Pelvic congestion syndrome. Semin Intervent Radiol 2013; 30 (04) 372-380
    Article in Thieme ConnectPubMedGoogle Scholar
  • 2 Koo S, Fan CM. Pelvic congestion syndrome and pelvic varicosities. Tech Vasc Interv Radiol 2014; 17 (02) 90-95
    CrossrefPubMedGoogle Scholar
  • 3 Geschwind JFH, Dake MD. Abrams Angiography: Interventional Radiology. 3rd revised ed.. Philadelphia, PA: Lippincott Williams and Wilkins; 2013
  • 4 d'Archambeau O, Maes M, De Schepper AM. The pelvic congestion syndrome: role of the “nutcracker phenomenon” and results of endovascular treatment. JBR-BTR 2004; 87 (01) 1-8
    PubMedGoogle Scholar
  • 5 Black CM, Thorpe K, Venrbux A. et al. Research reporting standards for endovascular treatment of pelvic venous insufficiency. J Vasc Interv Radiol 2010; 21 (06) 796-803
    CrossrefPubMedGoogle Scholar
  • 6 Kurklinsky AK, Rooke TW. Mayo Clinic Proceedings. Nutcracker phenomenon and nutcracker syndrome. Mayo Clin Proc 2010; 85 (06) 552-559
    CrossrefPubMedGoogle Scholar
  • 7 Kim HS, Malhotra AD, Rowe PC, Lee JM, Venbrux AC. Embolotherapy for pelvic congestion syndrome: long-term results. J Vasc Interv Radiol 2006; 17 (02) Pt 1 289-297
    CrossrefPubMedGoogle Scholar
  • 8 Laborda A, Medrano J, de Blas I, Urtiaga I, Carnevale FC, de Gregorio MA. Endovascular treatment of pelvic congestion syndrome: visual analog scale (VAS) long-term follow-up clinical evaluation in 202 patients. Cardiovasc Intervent Radiol 2013; 36 (04) 1006-1014
    CrossrefPubMedGoogle Scholar
  • 9 Wang X, Zhang Y, Li C, Zhang H. Results of endovascular treatment for patients with nutcracker syndrome. J Vasc Surg 2012; 56 (01) 142-148
    CrossrefPubMedGoogle Scholar
  • 10 Lozuk B, Tanaskovic S, Radak D, Babic S, Kovacevic V, Matic P. Infrarenal abdominal aorta aneurysm: a rare cause of anterior nutcracker syndrome with associated pelvic congestion. Ann Vasc Surg 2014; 28 (01) 263.e17-263.e20
    CrossrefPubMedGoogle Scholar