Implanting a stent for nutcracker syndrome
If the symptoms are clear, vascular support (stent implantation) can help. Using a catheter, a small tube (stent) is inserted into the narrowed renal vein via the inguinal vein under local anesthesia. This type of stent implantation is now considered the treatment of choice for nutcracker syndrome. The small tube then keeps the vein open and ensures sufficient blood flow again. Sometimes doctors place a plastic stent around the left renal vein. Extravascular stent implantation is the technical term for this. Stent implantation can usually be carried out in a minimally invasive procedure as part of a laparoscopy. As a rule, you only have to stay in hospital for one night.
Foam sclerotherapy for ovarian and testicular vein varices
If the congested left renal vein has led to the formation of a varicose vein in the ovary or testicular vein, this can be closed by injecting a special alcohol foam. This can be used to treat lower abdominal complaints.
Surgical interventions for nutcracker syndrome
In more severe cases, vascular surgery may be necessary to reduce the pressure on the left renal vein. An operation is recommended if:
- blood is repeatedly or permanently detected in the urine and causes anemia,
- Blood clots cause flank pain,
- you suffer from considerable pain,
- the disease has not improved after approximately two years of monitoring.
The following options are available:
- Detour (transposition) of the left renal vein or the superior mesenteric artery as part of an operation
- Bypass around the left renal vein: Doctors place a kind of “bypass” around the compressed vein to restore blood flow.
- Kidney autotransplantation: This procedure, in which the kidney is moved locally in the same person, produces good results, but is now only carried out if other treatments have not been successful.
After treatment, most patients are symptom-free and the prognosis for nutcracker syndrome is good.