Revascularização venosa via transposição de veia gonadal esquerda em síndrome de nutcracker posterior: relato de caso
Venous revascularization to treat posterior nutcracker syndrome by transposition of the left gonadal vein: case report
Guilherme Lourenço de Macedo; Matheus Alves dos Santos; Andrey Biff Sarris; Ricardo Zanetti Gomes
Resumo
Palavras-chave
Abstract
Abstract: The Nutcracker Syndrome is manifest in the presence of a symptomatic entrapment of the left renal vein between the abdominal aorta and the superior mesenteric artery. In a more ephemeral variation of this disorder, called the Posterior Nutcracker Syndrome, the renal vein is not compressed anterior to the aorta, but posteriorly, between the artery and the spine. Although there are multiple treatment options, current techniques aim to relieve the symptoms and reduce venous pressure on the left renal vein. This report describes a case of Posterior Nutcracker Syndrome in which the management approach chosen was open surgery, transposing the gonadal vein distally, to the inferior cava vein.
Keywords
References
Avgerinos ED, McEnaney R, Chaer RA. Surgical and endovascular interventions for nutcracker syndrome. Semin Vasc Surg. 2013;26(4):170-7. http://dx.doi.org/10.1053/j.semvascsurg.2014.06.014. PMid:25220323.
Hulsberg PC, Mcloney E, Partovi S, Davidson JC, Patel IJ. Minimally invasive treatments for venous compression syndromes. Cardiovasc Diagn Ther. 2010;6(6):582-92. http://dx.doi.org/10.21037/cdt.2016.10.01. PMid:28123978.
Ananthan K, Onida S, Davies AH. Nutcracker Syndrome: An update on current diagnostic criteria and management guidelines. Eur J Vasc Surg. 2017;3(6):886-94. http://dx.doi.org/10.1016/j.ejvs.2017.02.015. PMid:28356209.
Macedo GL, Santos MA, Sarris AB, Gomes RZ. Diagnóstico e tratamento da síndrome de quebra-nozes (nutcracker): revisão dos últimos 10 anos. J Vasc Bras. 2018;17(3):220-8. http://dx.doi.org/10.1590/1677-5449.012417. PMid:30643508.
Cunha Júnior JR, Souza TC, Feitosa AT, Brizzi JR, Tinoco JA. Tratamento endovascular da Síndrome de Quebra-nozes (Nutcracker). J Vasc Bras. 2013;12(3):247-51. http://dx.doi.org/10.1590/jvb.2013.034.
Skeik N, Gloviczki P, Macedo TA. Posterior Nutcracker Syndrome. Vasc Endovascular Surg. 2011;45(8):749-55. http://dx.doi.org/10.1177/1538574411419376. PMid:21890560.
Özkan MB, Ceyhan Bilgici M, Hayalioglu E. Anterior and posterior nutcracker syndrome accompanying left circumaortic renal vein in an adolescent: Case report. Arch Argent Pediatr. 2016;114(2):114-6. PMid:27079405.
Deser SB, Onem K, Demirag MK, Buyukalpelli R. Surgical treatment of posterior nutcracker syndrome presented with hyperaldosteronism. Interact Cardiovasc Thorac Surg. 2016;22(5):682-4. http://dx.doi.org/10.1093/icvts/ivw018. PMid:26892192.
Erben Y, Gloviczki P, Kalra M, et al. Treatment of nutcracker syndrome with open and endovascular interventions. J Vasc Surg Venous Lymphat Disord. 2015;3(4):389-96. http://dx.doi.org/10.1016/j.jvsv.2015.04.003. PMid:26992616.
Said SM, Gloviczki P, Kalra M, et al. Renal nutcracker syndrome: surgical options. Semin Vasc Surg. 2013;26(1):35-42. http://dx.doi.org/10.1053/j.semvascsurg.2013.04.006. PMid:23932560.
Benrashid E, Turley RS, Mureebe L, Shortell CK. Gonadal vein transposition in the treatment of nutcracker syndrome. J Vasc Surg. 2016;64(3):845. http://dx.doi.org/10.1016/j.jvs.2016.06.036. PMid:27318055.