Left renal vein compression syndrome: current approaches to diagnosis, treatment, and prognostic perspectives

Abstract

Nutcracker Syndrome, characterized by the compression of the left renal vein between the abdominal aorta and the superior mesenteric artery, presents clinical challenges due to its variability and diagnostic complexity. This article aims to review the diagnostic methodologies, treatment options, and prognostic perspectives of this condition. Using a narrative literature review, we explore advanced imaging techniques such as Doppler ultrasonography, computed tomography, and magnetic resonance imaging, which are essential for visualizing venous compression and quantifying the pressure gradient. Treatment options range from careful observation to invasive interventions like stent angioplasty and decompression surgeries. Therapeutic choice is influenced by symptom severity and the impact on the patient's quality of life, favoring personalized and evidence-based approaches. Results indicate that the prognosis is generally positive with early diagnosis and adequate treatment, although challenges remain in managing chronic and recurrent symptoms. This study highlights the importance of future research focused on optimizing diagnostic and therapeutic strategies, along with a better understanding of the underlying pathophysiological mechanisms of the syndrome. Such research is crucial for improving clinical outcomes and patient quality of life, promoting more effective and less invasive therapeutic innovations. This article contributes to the literature by providing a comprehensive overview of Nutcracker Syndrome, emphasizing the need for continuous advancements in the field.