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Article Abstract
Introduction: Management strategies for Nutcracker syndrome (NCS) differ across vascular and transplant surgery, with options such as left renal vein stenting and renal autotransplantation offering potential long-term pain relief.
Methods: A decision-analytic Markov state transition model was generated to simulate NCS management strategies over a two-year time horizon: Stent First, Autotransplantation, Stent Only, and No Intervention.
Results: Autotransplantation achieved the highest rate of pain resolution at 77.0 % followed by Stent First at 64.9 % after two years. Stent Only and No Intervention demonstrated the lowest rates of pain resolution at 51.8 % and 0 %, respectively. The estimated cumulative morphine milligram equivalents (MMEs) over the simulated two-year period were approximately 5037 MMEs for Autotransplantation, 7684 MMEs for Stent First, 10,556 MMEs for Stent Only, and 21,900 MMEs for No Intervention.
Conclusion: Renal autotransplantation was associated with higher rates of pain resolution and lower opioid usage over a simulated two-year period.
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| http://dx.doi.org/10.1016/j.amjsurg.2025.116567 | DOI Listing |
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