Management of left renal vein compression in patients presenting left gonadal vein reflux

Phlebology. 2018 Aug;33(7):475-482. doi: 10.1177/0268355517723992. Epub 2017 Aug 9.


Background Compression of left renal vein is an atypical cause of reflux in pelvic veins resulting in pelvic varices that in turn causes frequently lower limb varices in many cases. Methods A monocentric study was undertaken to report the treatment and five-year follow up of patients presenting left renal vein compression. Embolization of refluxive gonadal/pelvic veins was performed generally as the initial procedure. Left renal vein stenting was performed in patients presenting haematuria, severe lumbar pain or persistent pelvic/lower limb varices after embolization. Results From 462 cases of left renal vein compression, 40 were treated by stenting as first procedure. Four hundred twenty-two were treated by gonadal/pelvic vein embolization and only 15 needed complementary stenting. After follow-up, all cases with haematuria had improved and lumbar pain was eliminated in 81.5%. Patients with recurrent or persistant varices were all improved. Conclusion Left renal vein stenting should be considered an effective and safe procedure, with demonstrated durable efficacy and safety and no evidence of restenosis.

Keywords: Venous reflux; endovenous technique; nutcracker syndrome; stents.

MeSH terms

  • Adult
  • Aged
  • Back Pain* / etiology
  • Back Pain* / physiopathology
  • Back Pain* / surgery
  • Female
  • Follow-Up Studies
  • Hematuria* / etiology
  • Hematuria* / physiopathology
  • Hematuria* / surgery
  • Humans
  • Male
  • Middle Aged
  • Renal Veins* / physiopathology
  • Renal Veins* / surgery
  • Stents*
  • Vascular Diseases* / complications
  • Vascular Diseases* / physiopathology
  • Vascular Diseases* / surgery