Left Renal Vein Stent and Gonadal Vein Embolization in a Patient with Recurrent Varicocele and Nutcracker Syndrome—A Case Report

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Case Presentation: A 62-years-old male presented to the urology clinic complaining of infertility with history of bilateral testicular recurrent varicocele, and left varicocelectomy one year ago. Upon physical examination, the patient has atrophied testicles. Semen analysis showed oligospermia. CT scan showed compression of the left renal vein between the SMA and aorta indicating NCS Via right internal jugular vein access, catheterization of the left renal vein (LRV) was performed with difficulty passing the catheter beyond the stenotic segment in the LRV. Venography showed severe stenosis of the LRV. Selective cannulation of the left gonadal vein was done and embolization was done using multiple pushable coils and 3% concentration Sodium tetradecyl sulfate. Then, stenting of the LRV was done using 14 mm × 6 cm Venovo self-expandable bare stent (Bard Inc, USA). After that angioplasty was done using 12 mm × 4 cm. Final venogram showed patent stent. Publication History Article published online: 02 April 2024 © 2024. The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution License, permitting unrestricted use, distribution, and reproduction so long as the original work is properly cited. (https://creativecommons.org/licenses/by/4.0/) Georg Thieme Verlag KG Stuttgart · New York

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