Posterior Nutcracker Syndrome Caused by Abdominal Aortic Aneurysm: A Case Report.

Posterior-type nutcracker syndrome (NCS) is a rare disease characterized by the compression of the left renal vein between the aorta and the vertebral body. The optimal management strategy for NCS remains a subject of debate, with surgical intervention being considered for selected patients. Here we report the case of a 68-year-old male who presented with a one-month history of abdominal and flank pain as well as hematuria. Abdominal computed tomography angiography revealed the compression of left renal vein between an abdominal aortic aneurysm (AAA) and the vertebral body. The patient was suspected to have a posterior-type NCS, which significantly improved following open surgical repair of the AAA. In cases of posterior-type NCS, surgical intervention should be performed selectively in symptomatic patients, and open surgery is the preferred treatment modality for this condition. For posterior-type NCS associated with AAA, open surgical repair may represent the optimal choice for decompression of the NCS.

The Ability of Clinical Decision Rules to Detect Peripheral Arterial Disease: A Narrative Review.

Peripheral arterial disease (PAD) is a common cause of lower extremity wound. Consequently, PAD leads to a cause of leg amputation nowadays, especially in diabetic patients. In general practice (GP), confrontation with PAD prevention is a challenge. In general, ankle-brachial index (ABI) measurement can be used as a PAD diagnostic tool, but this takes some time. The tool is not generally available and this need to train healthcare workers to perform. Multiple independent predictors developed the diagnostic prediction model known as clinical decision rules (CDRs) to identify patients with high-risk PAD. This might therefore limit the number of patients (only high-risk patients) to refer for ABI evaluation. This narrative review summarized existing CDRs for PAD.