Nutcracker syndrome is an uncommon disease and should be easily overlooked. It is characterized by leftrenal vein entrapment between the abdominal aorta and the superior mesenteric artery. Hematuria andabdominal or flank pain are the most common symptoms. We present a 36-year-old female with chroniclower abdominal pain for 2 months. Computed tomography revealed extrinsic compression of the leftrenal vein by the aorta and superior mesenteric artery. Venography with pressure measurement showed a6-mmHg pressure gradient between the left renal vein and the inferior vena cava. Nutcracker syndromewas confirmed. Endovascular stenting was performed under intravascular ultrasound guidance. Afterprocedure, the pressure gradient between the left renal vein and inferior vena cava fell to 0-mmHg and hersymptoms resolved. Endovascular stenting is becoming popular among intervention therapies as it is lessinvasive with a satisfactory result. Intravascular ultrasound can provide more precise lesion informationand is helpful in stent sizing and identifying appropriate landing zone.
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