Endovascular stent placement for the treatment of nutcracker phenomenon in three pediatric patients.

Invasive treatment for nutcracker syndrome is controversial, especially in patients with a pediatric onset. Most patients are treated conservatively for a relatively long time, but severe hematuria with an intermittent exacerbation remained unchanged. Three pediatric patients presented with hematuria associated with or without mild proteinuria and were diagnosed as having nutcracker syndrome. The authors performed self-expandable endovascular stent placement across the left renal vein in these pediatric patients. Severe gross hematuria completely subsided after treatment and no serious complications are noted during 2- or 3-year follow-up; moreover, all patients have good physical development.