Prognostic benefit of surgical management in renal cell carcinoma patients with thrombus extending to the renal vein
and inferior vena cava: 17-year experience at a single center.
Taking into account the patient's distinctive anatomy, as well as his renal vein
and IVC tumour thrombus, the patient elected to undergo a left, open, midline radical nephrectomy with a renal vein
and IVC tumour thrombectomy.
The left renal vein
with clipped and transected adrenal and gonadal veins and the left renal artery 
Applying partial occluding clamp to exclude the IVC incision site, followed by removal of the clamps from the IVC and opposite renal vein
The nutcracker phenomenon (NCP) refers to the compression of left renal vein
(LRV) most commonly between the superior mesenteric artery (SMA) and aorta.
This case associates the left IVC with the more common anomaly of retroaortic right renal vein
Five patients (5/65, 8%) in the group of recipients who had received an OLDN kidney required reoperation, two with postoperative bleeding, one with a hyperacute rejection (again, confirmed histologically), one with infarction of the kidney secondary to renal vein
thrombosis and one with evidence of ureteric obstruction, for which ureteric revision with conversion to a ureteroureterostomy was required (Table 1).
2) Surrounding organ involvement is common as estimated left renal vein
involvement to be 48-51 percent, duodenum 97-100 percent, inferior vena cava 6370 percent, sigmoid colon 5-20 percent, and the ureters in 20-44 percent of cases (1).
The pathophysiology is similar to varicoceles in men and can be caused by incompetent valves, compression of the left renal vein
by the superior mesenteric artery, or venous obstruction from an anatomic variant such as a retroaortic left renal vein
Transplant operation mode was conventional right abdominal incision cadaveric kidney were used donor renal vein
and external iliac vein were end-to-side anastomosis donor renal artery and internal iliac artery were also end to side anastomosis.
Contrast abdominopelvic CT showed an old complete thrombosis of the left common iliac vein, recent complete thromboses of the left venous junctions (external and internal iliac veins, common femoral deep and superficial veins, ascending lumbar vein and various presacral collaterals), dilated azygos vein, partial eccentric thrombosis of the IVC, approximately 18 mm lower than the flow level of the right renal vein
, with a 5mm clot on a length of 27mm, with a reduced caliber on almost its entire length from the origin to the level of the caudate lobe.
Left testicular artery arching over the ipsilateral renal vein
Perforation of the renal pelvis was identified together with erosion of the left renal vein
in close contact with the calculus.
These studies suggest that iatrogenically induced hypervolemia, and increase in renal vein
pressure, lead directly to renal insufficiency independent of cardiac output or renal blood flow.
There was hilar congestion due to complex arrangement of unusually long pre-hilar portion of segmental veins draining into short renal vein