Prevalence and Relevance of Multiple Renal Arteries: A Radioanatomical Perspective

Pradhay, Girish; Gopidas, Geetha S; Pullara, Sreekumar Karumathil; Mathew, Georgie; Mathew, Asha J; Sukumaran, Tintu Thottiyil; Pavikuttan, Nanditha; Sudhakaran, Rathi

doi:10.7759/cureus.18957

Cited by 8 publications

(8 citation statements)

References 14 publications

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“…10,14,19 However, Jamkar AA et (75.01%), Cinar C et al (68.7%),Reginelli A et al (69%), Pradhav G et al (70%), Pant OB et al (67%) and Chhetri PK et al (67.76%) found higher prevalence of normal renal arterial system. 2,7,13,15,16,17 In our study, male and females had similar number of renal arterial variations. Similar findings were reported in studies by Palmiri BJ et al, Cinar C et al, Reginellia A et al and Chhetri PK et al 5,7,13,17 However, Gumus H et al found significantly higher variations in male cases.…”

Section: Discussionsupporting

confidence: 61%

“…Studies by Chhetri PK et al (54.84% right and 45.16 % left) and Pradhav G et al also found higher incidence of right sided renal arterial variations. 17,15 In studies by Palmeri B et al there was no statistical difference in variation of renal artery with laterality. 5 In our study early branching was the most common unilateral renal artery variation seen in 48.9% of variations.…”

Section: Discussionmentioning

confidence: 94%

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Variations of Renal Vasculature in Multi Detector Computed Tomography Evaluation of Abdomen

Paudel

Jha

Dahal

2022

J. Nepalgunj Med. College

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Introduction: Normal vascular supply to each kidney is by a single artery and vein on each side. This normal pattern is not found in all cases. Arterial variations can be accessory renal arteries which can be hilar, upper polar or lower polar and early branching. Venous variations can be late confluence, multiple renal veins and on left there can be retroaortic or circumaortic course of the left renal vein. Aims: To evaluate renal vasculature variations in patients who undergo contrast enhanced MultiDetector Computed Tomography of the abdomen. Methods: This was a hospital based cross sectional study done in 290 consecutive patients who underwent contrast enhanced Multi Detector Computed Tomography abdomen in Nepalgunj Medical College. Normal as well as variations in renal vasculature was evaluated. Results: Total of 158 (54.48%) cases had normal arterial supply. Out of 132 cases with renal arterial variation, 96 cases (72.7%) were unilateral and early branching was the most common unilateral renal arterial variation (36.4%) followed by upper polar (20.8%), lower polar (20.8%) and hilar (16.6%) arteries. Concurrent upper and lower polar arteries and combined early branching and lower polar arterial system were the most common multiple unilateral renal arterial variation seen in 2.08% cases respectively. 36 (27.27%) cases had bilateral renal arterial variations. Most cases had early branching in bilateral renal arteries seen in 9.09% cases. Venous variations were seen in 11.03%.Late confluence was the most common variation seen in 62.5% cases with variations. Rest were multiple renal veins. Left sided retroaortic and circumaortic course and bilateral renal vein variations were not found in our study. Conclusion: Renal vasculature variations were frequently observed in routine contrast enhanced Multi Detector Computed Tomography evaluation of abdomen. Renal arterial variation was more common than venous variations. Unilateral variations were more common than bilateral.

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Section: Discussionsupporting

confidence: 61%

Section: Discussionmentioning

confidence: 94%

Variations of Renal Vasculature in Multi Detector Computed Tomography Evaluation of Abdomen

Paudel

Jha

Dahal

2022

J. Nepalgunj Med. College

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“…MRA are present in 20%–30% of all individuals and pose technical challenges to transplant surgeons 34 . Given that most MRAs demonstrate a lack of collateral circulation, damage to one of the arteries may lead to ischemic necrosis of its supplied segment and result in graft loss.…”

Section: Discussionmentioning

confidence: 99%

Single versus multiple renal arteries in living donor kidney transplantation: A systematic review and patient‐level meta‐analysis

Lim

Fong

et al. 2023

Clinical Transplantation

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IntroductionGrafts with multiple renal arteries (MRAs) were historically considered a relative contraindication to transplantation due to the higher risk of vascular and urologic complications. This study aimed to evaluate graft and patient survival between single renal artery (SRA) and MRA living‐donor kidney transplants.MethodsAn electronic literature search was conducted on PubMed, EMBASE, and Scopus for prospective or retrospective studies comparing SRA versus MRA in living donor renal transplantation, with the provision of Kaplan–Meier curves for recipient overall survival (OS) or graft survival (GS). A graphical reconstructive algorithm was used to obtain OS and GS of individual patients, which was then pooled under random‐effects individual patient data (IPD) meta‐analysis using Cox‐models to determine hazard ratios (HRs) and 95% confidence intervals (CIs). Meta‐regression of baseline covariates versus HRs of OS and GS was performed for variables reported in 10 or more studies.ResultsFourteen studies were retrieved, of which 13 (8400 patients) reported OS and 9 (6912 patients) reported GS. There were no significant differences in OS (shared‐frailty HR = .94, 95%CI = .85–1.03, p = .172) or GS (shared‐frailty HR = .95, 95%CI = .83–1.08, p = .419) between SRA and MRA. This comparison remained non‐significant even when restricted to open‐ or laparoscopic‐only studies. Meta‐regression yielded no significant associations of GS with donor age, recipient age, and percentage of double renal arteries within the MRA arm.ConclusionsThe similar rates of GS and OS between MRA and SRA grafts suggest that there is no need for discrimination between the two when evaluating donors for nephrectomy.

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“…These results were comparable to the studies conducted in the past. [13,14] Short arteries may make vascular anastomosis more difficult and lengthen the period spent in warm ischemia during the operation, which makes their form and size critical in kidney donation. [15] We found frequency of anatomical variations of the renal vessel in 62 (68.9%) cases.…”

Section: Discussionmentioning

confidence: 99%

Evaluation of Clinical Implications of Renal Vessel Morphology during Renal Surgeries

Billah¹,

Raza²,

Qureshii³

et al. 2022

PJMHS

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Objective: Aim of this research to examine renal vessels and their morphologies as well as their clinical consequences during renal surgery. Study Design: Cross-sectional study Place and Duration: Anatomy department of Bacha Khan Medical Complex, Mardan and Multan Medical & Dental College Multan during the period from April 2022 to September 2022. Methods: There were 90 cases of both genders presented in this study. Included patients were aged between 20-80 years. With suspected abdominal diseases, patients were referred for abdominal CECT examinations. In contrast-enhanced MDCT images of the Abdomen, the renal arteries were examined for their normal structure and any abnormalities. SPSS 21.0 was used to analyze complete data. Results: Males were higher in numbers 61 (67.8%) than females. Mean age of the patients was 51.3±8.43 years and mean BMI 22.4±8.42 kg/m2. We found frequency of anatomical variations of the renal vessel in 62 (68.9%) cases. Frequency of variations of the renal artery was 47 (52.2%). Among 47 cases, supplementary renal artery was found in 41 (45.6%) cases. Early bifurcation of renal artery in 15 (16.7%). In 11 patients on the right side, 12 patients on the left side, and 3 individuals on both sides, an earlier branching of the renal artery was found. The right side was more often affected by renal vein variations, with 25 (278%) patients having late renal vein confluence and 6 (6.7%) patients having additional renal veins. Patients with late renal vein confluence (3.3%) and retroaortic vein (3.3%) were seen on the left side. Conclusion: Our findings in this research show renal artery alterations are common. Endovascular, laparoscopic, and urological procedures benefit from morphological examination of the renal vessels. Keywords: Abdominal disease, Renal Artery, Conventional Angiography, Anatomical Variations

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Prevalence and Relevance of Multiple Renal Arteries: A Radioanatomical Perspective

Cited by 8 publications

References 14 publications

Variations of Renal Vasculature in Multi Detector Computed Tomography Evaluation of Abdomen

Variations of Renal Vasculature in Multi Detector Computed Tomography Evaluation of Abdomen

Single versus multiple renal arteries in living donor kidney transplantation: A systematic review and patient‐level meta‐analysis

Evaluation of Clinical Implications of Renal Vessel Morphology during Renal Surgeries

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