Nutcracker Syndrome
We provide structured assessment to identify patients who may benefit from specialist imaging and referral to vascular or interventional teams when appropriate.
under-recognised vascular compression condition that can cause pelvic pain, haematuria, and atypical venous reflux patterns. Because symptoms often overlap with pelvic venous disease, diagnosis is frequently delayed or missed.
What is nutcracker syndrome?
Nutcracker syndrome occurs when the left renal vein becomes compressed, most commonly between the aorta and the superior mesenteric artery. This compression disrupts venous drainage from the kidney and pelvis, leading to increased venous pressure.
As a result, patients may develop:
- pelvic congestion symptoms
- flank or abdominal discomfort
- haematuria (blood in urine)
- vulval or pelvic varices
- atypical thigh varicosities
- persistent left-sided venous symptoms
Who should attend this clinic?
You may benefit from assessment if you have:
- unexplained pelvic pain
- haematuria without a clear urological cause
- vulval or pelvic varices
- atypical left-sided varicose veins
- symptoms suggestive of pelvic congestion syndrome
- recurrent venous disease not explained by truncal reflux
These patterns may indicate upstream venous compression rather than isolated lower-limb disease.
Our role as your diagnostic gateway
Our clinic specialises in identifying patients who may have renal vein compression. Even without performing embolisation procedures onsite, we provide structured assessment and referral pathways so patients reach the right specialists efficiently.
During assessment, we:
- review symptom history and previous investigations
- assess patterns of pelvic-origin venous reflux
- evaluate atypical lower-limb venous presentations
- identify features suggestive of renal vein compression
- determine whether cross-sectional imaging is appropriate
- arrange referral to specialist vascular or interventional radiology services when indicated
This structured pathway ensures patients access the right expertise efficiently.
