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National Journal of Clinical Anatomy
Article . 2023 . Peer-reviewed
Data sources: Crossref
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Variations of Nutcracker Phenomenon

A Cadaveric and Computed Tomography Angiographic Study
Authors: Anisha Nautiyal; Deepika Sharma; Anjali Sharan; Piyush Kumar; Swati Saxena; Rajesh Maurya; Sonam Maheshwari; +2 Authors

Variations of Nutcracker Phenomenon

Abstract

Introduction: The nutcracker phenomenon (NCP) (or the left renal vein [LRV] entrapment) focuses on the constriction of the LRV. It occurs commonly between the abdominal aorta (AA) and the superior mesenteric artery. The resulting clinical manifestation of this phenomenon is known as the nutcracker syndrome (NCS). Three types of this phenomenon have been reported: anterior, posterior, and mixed. NCP is a rare finding as reported by various authors. The aim of this study is to know the prevalence of NCP in the population of Uttarakhand, India. Methodology: The study was conducted to understand the tributaries of the renal veins and any variations in their pattern via 160-slice computed tomography (CT) angiography. CT angiographies were retrospectively studied to study the renal vasculature. A total of 14 renal veins which included four accessory renal veins (aRVs) (one left and three right) were analyzed from cadaveric dissection and 44 CT films were included (36 males and eight females) with 98 renal veins which included 10 aRVs (three left and seven right). Results: The current study was done on 49 cases (five cadavers and 44 CT angiography), in which a 10.2% prevalence of NCP was recorded. All were variants of mixed types of NCP. Conclusion: Although the NCP and NCS are rare occurrences, it has been determined that it was possibly underdiagnosed due to a lack of the proper advanced imaging and diagnostic modalities. Hence, it led to the undertreatment of the same. With recent development in diagnostic modalities such as multidetector CT, CT angiography, magnetic resonance angiography, etc., there has been a rise in diagnosis of NCP and NCS, thus resulting in increased prevalence.

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Keywords

renal vein entrapment syndrome, nutcracker syndrome, ct angiography, Human anatomy, QM1-695, nutcracker phenomenon

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selected citations
These citations are derived from selected sources.
This is an alternative to the "Influence" indicator, which also reflects the overall/total impact of an article in the research community at large, based on the underlying citation network (diachronically).
BIP!Citations provided by BIP!
popularity
This indicator reflects the "current" impact/attention (the "hype") of an article in the research community at large, based on the underlying citation network.
BIP!Popularity provided by BIP!
influence
This indicator reflects the overall/total impact of an article in the research community at large, based on the underlying citation network (diachronically).
BIP!Influence provided by BIP!
impulse
This indicator reflects the initial momentum of an article directly after its publication, based on the underlying citation network.
BIP!Impulse provided by BIP!
1
Average
Average
Average
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