Nutcracker Syndrome | Left Renal Vein Compression | MedStar Health

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A team of vascular surgeons from MedStar Health.

Compression of the vein that carries blood filtered by the left kidney

Left renal vein compression, or nutcracker syndrome, occurs when the left renal vein is squeezed or compressed by surrounding arteries of the body. This can cause renal venous hypertension (high blood pressure in the kidney veins) and veins to rupture.

The most common type of nutcracker syndrome is anterior compression, in which the left renal vein is pinched between the abdominal aorta and another artery. Compression between the abdominal aorta and the spine is called posterior nutcracker syndrome.

Although some people may not experience any symptoms, they often are more severe when you are active. Symptoms may include:

  • Blood or protein in the urine

  • Enlarged ovarian veins (women) or scrotal veins (men)

  • Lightheadedness when standing

  • Palpitations, the sensation that the heart rate is skipping, slowing down, or racing

  • Pain in the pelvic area, upper abdomen, back, or sides

Tests

Diagnosing left renal vein compression is the first step to developing a treatment plan. Our specialists may recommend one or more diagnostic and imaging procedures.

Arterial Duplex Ultrasound for Arms and Legs

Arterial duplex ultrasound uses Doppler and traditional ultrasound to assess blood flow in the arteries of your arms and legs.

Treatments

Although left renal vein compression may resolve on its own, some cases will require treatment to avoid complications, such as anemia, blood clots, or kidney damage. Your doctor will evaluate your condition and implement an individualized treatment plan.

Renal Artery Stenting

Renal artery stenting is used to open blocked or narrowed arteries that supply blood to the kidneys.

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