Commentary on “Renal Vein Stenting via the Right Internal Jugular Vein Approach With a Provocative Valsalva Maneuver to Reduce the Risk of Stent Migration”
Abstract
PVSsppvsPerspect Vasc Surg Endovasc TherPerspectives in Vascular Surgery and Endovascular Therapy1531-00351521-5768SAGE PublicationsSage CA: Los Angeles, CA10.1177/153100351142933210.1177_1531003511429332Focus on Venous StentsCommentary on “Renal Vein Stenting via the Right Internal Jugular Vein Approach With a Provocative Valsalva Maneuver to Reduce the Risk of Stent Migration”PittalugaPaulMDChastanetSylvainMDBjarnasonHaraldurMD11Division of Interventional Radiology, Gonda Vascular Center, Mayo Clinic, Rochester, MinnesotaHaraldur Bjarnason, MD, 200 First Street SW, Rochester, Minnesota 55905 Email: Bjarnason.Haraldur@mayo.edu122011234Special Issue: Update on Chronic Venous Disease272273© The Author(s) 20112011SAGE PublicationsThe nutcracker syndrome has a complex presentation and is uncommon, which makes the diagnosis difficult. The treatment for nutcracker syndrome has traditionally been surgical, but with so many other vascular conditions, endovascular treatment is now making inroads into the management of this condition as well.1It was with great interest that I read this article, which points out some of the problems that we encounter with procedures in the venous system in general. By nature the venous system is a vascular “capacitor” or vascular storage space and is therefore very compliant. The patient’s hydration status, for one, significantly affects the diameter of the veins, and as pointed out by Drs Syed and Yu, even normal physical activity can significantly affect the diameter of the vessels.Murphy et al