A STUDY ON ANATOMICAL VARIATIONS OF RENAL VESSELS

Main Article Content

Dr. Vimala Devi M
Dr Deepalaxmi S
Dr. Somashekara S C

Keywords

developmental anomalies, renal surgery, renal vessels, variations

Abstract

Introduction: The unique manner of the development of the kidneys and renal vessels predisposes them to a wide range of variations and anomalies. Knowledge of anomalous renal blood vessels is very important in clinical and surgical practice. It is very much necessary to have accurate anatomic visualization of kidneys and renal vessels during surgeries especially during renal transplant since the variations and anomalies influence the technical feasibility of surgery.


Objectives: To know the various developmental anomalies pertaining to renal vessels in adult cadavers and term foetuses.


Materials and methods: The dissection method was adopted for the present study. Total number of specimens studied in present work is 30, among which 20 were adult cadavers and 10 were foetal cadavers. Foetuses were obtained from the department of obstetrics and gynaecology. Foetuses were numbered F1 to F10 and cadavers from C1 to C20. Photographs were taken after dissection. As any abnormalities appeared, necessary observations were made and summarised.


Results: Out of 10 foetal & 20 adult cadaver dissections, morphological variations found in the renal arteries was 15% and venous anomalies in 5%, perforating renal arteries in 15%, double renal arteries in 10%, multiple renal arteries 5 %, Additional renal veins were found in 5%, interposition of renal veins at hilum 5%. Of the ten foetuses studied, none revealed any anomaly.


Conclusion: Variations of renal vessels have been encountered with increasing frequency over past few years owing to the technological investigations like angiography and other imaging modalities. Knowledge of these variations is very much essential to perform renal surgeries.

Abstract 83 | pdf Downloads 42

References

1. Lipshutz B, Hoffman C. Renal arterial variations and extraperitoneal abdominal nephrectomy. Ann Surg. 1926 Oct;84(4):525-32. PMID: 17865547; PMCID: PMC1399149.
2. K.S.Satyapal, The renal veins: a review, Eur J Anat, 7 Suppl. 1:43-52 (2003)
3. Vilhova I, Kryvko YY, Maciejewski R. The radioanatomical research of plural renal arteries. Folia Morphol (Warsz). 2001 Nov;60(4):337-41. PMID: 11770346.
4. Young AH, Thompson P. Abnormalities of the Renal Arteries, with Remarks on their Development and Morphology. J Anat Physiol. 1903 Oct;38(Pt 1):1-14.1. PMID: 17232579; PMCID: PMC1287385.
5. Bayazit M, Göl MK, Zorlutuna Y, Tasdemir O, Bayazit K. Bilateral triple renal arteries in a patient with iliac artery occlusion: a case report. Surg Radiol Anat. 1992;14(1):81-3. doi: 10.1007/BF01628048. PMID: 1589852.
6. Kadir S. Kidneys. In: Kadir S, editor. Atlas of normal and variant angiographic anatomy. Philadelphia: Saunders; 1991. pp. 387–428.
7. Park BS, Jeong TK, Ma SK, Kim SW, Kim NH, Choi KC, Jeong YY. Hydronephrosis by an aberrant renal artery: a case report. Korean J Intern Med. 2003 Mar;18(1):57-60. doi: 10.3904/kjim.2003.18.1.57. PMID: 12760271; PMCID: PMC4531603.
8. Shakeri AB, Tubbs RS, Shoja MM, Pezeshk P, Farahani RM, Khaki AA, Ezzati F, Seyednejad F. Bipolar supernumerary renal artery. Surg Radiol Anat. 2007 Feb;29(1):89-92. doi: 10.1007/s00276-006-0158-0. Epub 2006 Oct 24. PMID: 17061029.
9. Patel Shashikala, Wanjari Anjali, Naik Anshuman, Deshpande Jayshree. A case report: double renal arteries. Int. J Anat 2012; 5:22-24.
10. Nishimura K, Maeda T, Hiroe T, Honda T, Kamihira S, Kanaoka Y, Ohgi S. Left renal artery aneurysm with left accessory renal arteries. A case report. Int Angiol. 2002 Mar;21(1):103-6. PMID: 11941283.
11. Pestemalci T, Mavi A, Yildiz YZ, Yildirim M, Gumusburun E. Bilateral triple renal arteries. Saudi J Kidney Dis Transpl. 2009 May;20(3):468-70. PMID: 19414954.
12. Dhar P, Lal K. Main and accessory renal arteries--a morphological study. Ital J Anat Embryol. 2005 Apr-Jun;110(2):101-10. PMID: 16277160.
13. Mehta, Gyata&Arole, Vasanti. (2014). Accessory Renal Arteries: A Cadaveric Study. International Journal of Biomedical and Advance Research. 5. 204. 10.7439/ijbar.v5i4.727.
14. Ramulu, M. V., & Prasanna, L. C. (2017). Morphometric evaluation of the kidney and its main renal artery. International Journal of Research in Medical Sciences, 3(2), 429–432.
15. Thejodhar P, Kumar Po, Rao MS, et al. Co-existence of circumaortic renal collar, accessory renal artery and anomalous arrangement of hilar structures in the same cadaver: A case report. Eur J Anat. 2007; 11: 185–188.
16. Huntington, G. S. & McClure, C. F. W. (1907a).Development of the postcava and tributaries in the domestic cat. The Anat. Rec. 1(3), 29-30
17. Bass JE, Redwine MD, Kramer LA, Huynh PT, Harris JH Jr. Spectrum of congenital anomalies of the inferior vena cava: cross-sectional imaging findings. Radiographics. 2000 May-Jun;20(3):639-52.
18. Aljabri B, MacDonald PS, Satin R, Stein LS, Obrand DI, Steinmetz OK. Incidence of major venous and renal anomalies relevant to aortoiliac surgery as demonstrated by computed tomography. Ann Vasc Surg. 2001 Nov;15(6):615-8. doi: 10.1007/s10016-001-0095-7. PMID: 11769141.
19. Trigaux JP, Vandroogenbroek S, De Wispelaere JF, Lacrosse M, Jamart J. Congenital anomalies of the inferior vena cava and left renal vein: evaluation with spiral CT. J VascIntervRadiol. 1998 Mar-Apr;9(2):339-45. doi: 10.1016/s1051-0443(98)70278-7. PMID: 9540920.
20. Lin CH, Steinberg AP, Ramani AP, Abreu SC, Desai MM, Kaouk J, Goldfarb DA, Gill IS. Laparoscopic live donor nephrectomy in the presence of circumaortic or retroaortic left renal vein. J Urol. 2004 Jan;171(1):44-6. doi: 10.1097/01. ju.0000099895.62724.04. PMID: 14665840.
21. Walker TG, Geller SC, Delmonico FL, Waltman AC, Athanasoulis CA. Donor renal angiography: its influence on the decision to use the right or left kidney. AJR Am J Roentgenol. 1988 Dec;151(6):1149-51. doi: 10.2214/ajr.151.6.1149. PMID: 3055890.
22. Park BS, Jeong TK, Ma SK, Kim SW, Kim NH, Choi KC, Jeong YY. Hydronephrosis by an aberrant renal artery: a case report. Korean J Intern Med. 2003 Mar;18(1):57-60. doi: 10.3904/kjim.2003.18.1.57. PMID: 12760271; PMCID: PMC4531603.
23. Ranade AV, Rai R, Prahbu LV, Mangala K, Nayak SR. Arched left gonadal artery over the left renal vein associated with double left renal artery. Singapore Med J. 2007 Dec;48(12):e332-4. PMID: 18043830.
24. Vilhova I, Kryvko YY, Maciejewski R. The frequency of different plural renal arteries rare variants. Ann Univ Mariae Curie Sklodowska Med. 2002;57(2):68-73. PMID: 12898821.