We report the efficacy and safety of endovascular stenting for nutcracker syndrome at long-term followup. We retrospectively evaluated the endovascular stenting experience with 61 patients with a median age of 26 years. Symptoms were hematuria, proteinuria or flank pain. Median followup was 66 months. Peak velocity in the aortomesenteric portion, and the anteroposterior diameter ratio of the renal hilum and the aortomesenteric portion of the left renal vein on Duplex ultrasound after stenting was significantly decreased compared to that on Duplex ultrasound before stenting (p0.05). Symptoms resolved or improved in 15, 24 and 20 of the 61 patients within 1 week, and 1 and 6 months, respectively, after endovascular stenting. Symptoms remained unchanged in 2 patients and recurred in 1. A perioperative complication was noted in 1 patient, that is a stent that was mistakenly moved and poorly deployed in a left renal vein collateral required operative intervention. Postoperative complications included stent migration into the right atrium, stent protrusion into the inferior vena cava and stent migration into the hilar left renal vein in 1 case each. Based on our long-term followup endovascular stenting is a safe, effective procedure in select adults. We recommend endovascular stenting as primary option for nutcracker syndrome.

Aortic aneurysm is a cardiovascular condition with a serious risk of mortality and the dismal prognosis of any type of major cardiovascular disease. The present study found that tissues from aortic aneurysm patients and hypoxic aortic smooth muscle cells showed aberrant high expression of the cyclic RNA hsa‑circ‑000595, as demonstrated by polymerase chain reaction array screening. Knockdown of hsa‑circ‑000595 resulted in a decreased apoptotic rate of human aortic smooth muscle cells. Furthermore, it was determined that miR‑19a is a target of hsa‑circ‑000595. The results of the present study laid an epigenetic foundation for exploring the underlying mechanisms of the development of aortic aneurysm.