Nutcracker occurs when the left renal vein is compressed between the abdominal aorta and the superior mesenteric artery. When symptomatic (left flank pain, hematuria) it is called nutracker syndrome. If asymptomatic is called nutcracker phenomena. In this example, the patient had complaints of pelvic congestion only.
87 year old with severe left leg claudication limiting ability to walk more than 100 feet
Percutaneous bypass graft for severe critical limb ischemia