Saphenous Bypass for Treating Anterior Nutcracker Syndrome After Failed Renal Vein Transposition: A Case Report

Vasc Endovascular Surg. 2025 Oct;59(7):783-787. doi: 10.1177/15385744251355225. Epub 2025 Jul 2.

Abstract

AimTo report on a case of renal vein anterior nutcracker syndrome (ANCS) that was treated using saphenous vein bypass after a failed attempt of renal vein transposition.CaseA 42-year-old female presented with gross hematuria and flank pain. Computed tomography revealed a left renal vein (LRV) anterior nutcracker syndrome. An attempt to perform LRV transposition failed due to short vein length. A saphenous bypass was then harvested to perform a bypass between the inferior vena cava and LRV. At 6-month follow-up, the patient remained symptom-free, and imaging confirmed graft patency.ConclusionSaphenous vein bypass presents a viable option in patients with short renal vein or failed renal vein transposition in cases of ANCS.

Keywords: case report; hematuria; nutcracker syndrome; renal vein transposition; saphenous bypass.

Publication types

  • Case Reports

MeSH terms

  • Adult
  • Computed Tomography Angiography
  • Female
  • Humans
  • Phlebography / methods
  • Renal Nutcracker Syndrome* / diagnostic imaging
  • Renal Nutcracker Syndrome* / physiopathology
  • Renal Nutcracker Syndrome* / surgery
  • Renal Veins* / diagnostic imaging
  • Renal Veins* / physiopathology
  • Renal Veins* / surgery
  • Saphenous Vein* / diagnostic imaging
  • Saphenous Vein* / physiopathology
  • Saphenous Vein* / transplantation
  • Treatment Failure
  • Treatment Outcome
  • Vascular Grafting*
  • Vascular Patency