ReviewCardiovascular diagnosis and therapy2021
Nutcracker syndrome: diagnosis and therapy.
Review in Cardiovascular diagnosis and therapy, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 49 papers, 1 of them a synthesis that pooled it.
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The trial behind it
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Who cites it
49 citing papers in PubMed, 1 synthesis or guideline pooled it, 86 citations in OpenAlex.
- The superior mesenteric artery angle in diagnosis of nutcracker syndrome: a systematic review and meta-analysis.Abdominal radiology (New York) · 2025Pooled it
- Wilkie syndrome combined with nutcracker syndrome presented as syncopal episodes: A case report.Radiology case reports · 2026Article
- Combined nutcracker syndrome and glomerulonephritis in pediatric patients: a single-center retrospective case series.Kidney research and clinical practice · 2026Article
- Wilkie's syndrome as the cause of intestinal obstruction in an 18-year-old female adolescent: A case report.Radiology case reports · 2026Article
- Open surgery appears to be the preferred treatment in patients with nutcracker syndrome: A vascular low frequency disease consortium analysis.Journal of vascular surgery. Venous and lymphatic disorders · 2026Article
- Spinal venous hypertension secondary to nutcracker syndrome-a previously unreported cause of congestive myelopathy.BMC urology · 2026Article
- Laparoscopic and robotic extravascular stenting of the left renal vein for anterior nutcracker syndrome in a single-center series.Journal of vascular surgery. Venous and lymphatic disorders · 2026Article
- Nutcracker syndrome in 2026: a nephrologist-oriented diagnosis and management.Clinical kidney journal · 2026Review
- Aorto-mesenteric space reduction in women with anorexia nervosa: retrospective audit and analysis.Journal of eating disorders · 2026Article
- Using finite element analysis to obtain the pressure gradient between the left renal vein and the inferior vena cava: a new method for the diagnosis and follow-up of patients with nutcracker syndrome.Quantitative imaging in medicine and surgery · 2026Article
- Reoperative robotic laparoscopic extracorporeal stent implantation following the failure of endovascular stent implantation for nutcracker syndrome.Journal of vascular surgery cases and innovative techniques · 2026Article
- Surgical management of Nutcracker syndrome caused by a middle mesenteric artery in an adolescent.Journal of vascular surgery cases and innovative techniques · 2026Article
- Cognitive impairment in idiopathic intracranial hypertension: A conceptual framework and therapeutic implications.Surgical neurology international · 2026Review
- Pediatric Varicocele as the Presenting Sign of Nutcracker Syndrome: An Ultrasound Case Report.International medical case reports journal · 2026Article
- Percutaneous left renal vein stenting in posterior nutcracker syndrome: technical and antithrombotic nuances - a case report.Frontiers in cardiovascular medicine · 2026Article
- A suggestive case report of posterior "Nutcracker syndrome" at computed tomography, and review of the literature.Radiology case reports · 2026Article
- Left renal vein transposition as a treatment of refractory hypertension in nutcracker syndrome.Journal of vascular surgery cases and innovative techniques · 2025Article
- Breaking the Nutcracker: a case-based review of diagnosis and surgical treatment.Journal of surgical case reports · 2025Article
- Gastrointestinal Obstruction Secondary to Wilkie's Syndrome: A Case Report of a Rare Clinical Presentation.Cureus · 2025Article
- [Transposition of the Superior Mesenteric Artery at the Infrarenal Segment of the Aorta in "Nut Cracker Syndrome"].Zentralblatt fur Chirurgie · 2025Review
Corrections and comments
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Authors and funding
5 authors at 2 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Nutcracker syndrome (NCS) is an extrinsic compression of the left renal vein (LRV) by the superior mesenteric artery (SMA) anteriorly and aorta posteriorly resulting in renal vascular congestion manifesting as hematuria, proteinuria, orthostatic hypotension, pain, or even renal dysfunction. Long-standing venous compression can encourage collateral drainage pathways through gonadal and pelvic veins, which may explain reported symptom and syndrome overlap with pelvic congestion syndrome. Diagnosis can be challenging and variable, frequently involving a combination of ultrasound Doppler, cross-sectional, and invasive imaging. Often, intravascular pressure measurements are required to prove a renocaval pressure gradient to aid in a definitive diagnosis. Conservative management is appropriate, especially in children, who tend to outgrow the disorder. In the interim, medical management with angiotensin converting enzyme inhibitors (ACEIs) is a useful therapy to manage orthostatic hypotension in the pediatric population. In adults, invasive therapies are more frequently pursued. These are aimed at relieving the extrinsic compression on the LRV. The standard of care is renal vein transposition, with renal autotransplantation reserved for recalcitrant cases. Endovascular stenting is a less invasive option. Laparoscopic placement of an exovascular stent is a newer therapy intended to minimize trauma to the LRV. In this review, we will discuss the clinical manifestations, diagnostic criterion, imaging features, and conservative and surgical therapies for this condition.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.