Associação entre as síndromes de quebra-nozes e May-Thurner: revisão integrativa

Abstract

Nutcracker Syndrome is typically characterized by the compression of the Left Renal Vein (LRV) between the Superior Mesenteric Artery (SMA) and the Aorta (4). There are two other possible presentations, which occur when there are anatomical variations in the positioning of the LRV, namely the presence of a circumaortic venous ring and a posterior position. All three presentations can lead to symptoms of pelvic congestion (6). May-Thurner Syndrome occurs with the compression of the left iliac vein (LIV) by the right iliac artery (RIA) against the spine (1), leading to congestion in the left leg and resulting complications (1,8). The combination of these syndromes can exacerbate clinical presentation, complicate diagnosis, and delay treatment (9). The treatment is not standardized and may involve invasive interventions, clinical management, or expectant management depending on the symptomatology (9,21–25). The present work reviewed the topic, addressing the main clinical, diagnostic, and therapeutic aspects of each syndrome individually and their association. All publications on the overlap of the syndromes were reviewed, and the results are presented in the text.