Utility of magnetic resonance imaging in establishing a venous pressure gradient in a patient with possible nutcracker syndrome

Nutcracker syndrome is characterized by abnormal acute angulation of the superior mesenteric artery origin from the aorta, with resulting compression and hypertension of the crossing left renal vein. The radiologic studies used in diagnosis are typically limited to standard cross-sectional anatomic imaging with computed tomography or magnetic resonance imaging, with occasional use of Doppler ultrasound imaging for hemodynamic quantification. The standard for acquiring anatomic and physiologic information continues to be invasive venography. We describe the successful novel application of phase-encoded magnetic resonance imaging as a noninvasive method for acquiring anatomic and hemodynamic data in a case of possible nutcracker syndrome in a young patient

Congenital absence of the inferior vena cava with bilateral iliofemoral acute deep venous thrombosis

Iliofemoral acute deep venous thrombosis (DVT) poses increased risk for post-thrombotic syndrome. Absent inferior vena cava (IVC) syndrome is a rare vascular anomaly that can be associated with idiopathic DVT in the young patient. It remains unclear whether endovenous thrombolytic intervention for DVT in patients with absent IVC can be successful, given the impaired venous outflow. This case report describes revascularization of bilateral iliofemoral and femoropopliteal DVT using endovascular pharmacomechanical thrombolysis and thrombectomy in a patient with underlying absent IVC syndrome to prevent post-thrombotic morbidity