Nutcracker syndrome, also known as left renal vein compression, occurs when the left renal vein is compressed—often between the aorta and the superior mesenteric artery—leading to symptoms like flank pain and blood in the urine. At St. Louis Vascular Surgical Specialists, board-certified vascular surgeon Dr. Robert Hacker offers expert evaluation and treatment for this rare but impactful condition.
Nutcracker Syndrome: An Overview
Nutcracker syndrome is a vascular condition caused by compression of the left renal vein, most commonly between the abdominal aorta and the superior mesenteric artery. This pressure can lead to impaired blood flow from the kidney, resulting in symptoms like hematuria (blood in the urine), flank pain, pelvic congestion, or varicoceles in men. Though rare, the condition can significantly affect an individual’s quality of life when left untreated.
Diagnosis often involves advanced imaging studies, including Doppler ultrasound, CT angiography, or venography to confirm vein compression and assess pressure gradients. At St. Louis Vascular Surgical Specialists, Dr. Hacker applies his expertise in vascular surgery to provide accurate diagnosis and a full spectrum of treatment options, including conservative management, endovascular stenting, or surgical vein transposition.
Potential symptoms of nutcracker syndrome:
- Flank or abdominal pain
- Blood in the urine (hematuria)
- Pelvic pain or pressure
- Left-sided varicocele in men
- Orthostatic proteinuria
- Fatigue or dizziness
- Nausea or gastrointestinal discomfort
- Pain with urination
- Pain during or after exercise
- Menstrual irregularities or pelvic congestion in women
Personalized vascular treatment options at SVSS
At St. Louis Vascular Surgical Specialists, your care begins with a thorough evaluation. Dr. Hacker will meet with you personally to understand your symptoms, review your medical history, and conduct any necessary imaging studies to confirm a diagnosis of nutcracker syndrome. These tests may include Doppler ultrasound, CT angiography, or venography to assess the degree of vein compression and associated pressure changes.
Dr. Hacker will create a treatment plan tailored to your specific condition and lifestyle. If your symptoms are mild, he may recommend conservative management and monitoring. For more advanced cases, he offers minimally invasive options such as endovascular stenting or surgical interventions like renal vein transposition. Every step of your care is designed to reduce symptoms, restore circulation, and help you return to a more comfortable, active life.
Schedule your consultation with Dr. Hacker
St. Louis Vascular Surgical Specialists is led by Dr. Robert Hacker, a double board-certified and fellowship-trained vascular surgeon with expertise in diagnosing and treating complex vein and artery conditions. We’re dedicated to delivering compassionate, individualized care with a strong focus on long-term vascular health. Whether you’re experiencing symptoms of nutcracker syndrome or another vascular concern, we encourage you to schedule your consultation and take the first step toward the attentive, expert care you deserve.
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At St. Louis Vascular Surgical Specialists, we are committed to providing accessible, high-quality care. We accept most major insurance plans to help meet your healthcare needs. For questions about coverage or to verify your insurance, please contact our office today.