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Abstract

The Renal arteries, which supply the kidney, originate from anterolateral or lateral branches of the abdominal aorta at the level of L1-L2 vertebrae,below the superior mesenteric artery. The failure of the lateral branches of the embryologic mesonephrons to degenerate results in many variations in the anatomy of the renal artery. Double renal arteries is the most common of these variations. A 67 year old male patient was admitted to Meram Medicine Faculty with severe abdominopelvic pain. A double renal artery variation was detected during CT angiography. In the literature, reported rates for variation of the root of the renal artery range from 11 % to 30.9 %. Failure of transplantation is seen more frequently with kidneys supplied by double renal arteies than that of kidneys supplied by a single artery. Furthermore, the frequency of variation of the anatomy of the renal artery shows social, ethnical and racial differences. We believe that our findings will increase the awareness of renal artery variations and positively impact the success of surgical procedures

Keywords

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ARTERIA RENALİS DEXTRA VARYASYONU

Abstract

Böbreği besleyen arteria renalis lumbal 1. (L1) ve 2. (L2) lumbal vertebra seviyesinden, arteria mesenterica superior’un hemen altında aorta abdominalis’in anterolateral ya da lateral kısmından çıkar. Embriyonik damar olan mesonefronların lateral dallarının erişkinlikte kaybolmaması nedeniyle arteria renalis anatomisi oldukça varyasyon gösterir. Renal morfolojik varyasyonlar arasında en sık karşılaşılan çift arteria renalis varyasyonudur. Meram Tıp Fakültesi Hastanesine, postprandiyal abdominal ağrı ile başvuran 67 yaşındaki erkek hastanın incelenen bilgisayarlı tomografi görüntülerinde arteria renalis varyasyonuna rastlandı. Literatürde arteria renalis’in kök varyasyonlarına dair %11 ile %30,9 arasında değişen farklı değerler verilmektedir. Çift arteria renalis ile beslenen böbrek transplantasyonlarında görülen başarısızlık, varyasyon göstermeyen böbrek transplantasyonlarına göre daha yüksek oranda görülmektedir. Diğer yandan arteria renalis varyasyon sıklığının, sosyal, etnik ve ırksal farklılıklar gösterdiği bilinmektedir. Bu çalışmadan elde ettiğimiz sonuçların; karşılaşılabilecek varyasyonlara olan farkındalığı arttıracağını ve cerrahi yönetimin başarısını olumlu yönde etkileyeceğini düşünmekteyiz.

Keywords

• Arteria renalis, Varyasyon, Bilgisayarlı Tomografi

References

1. Patasi B, Boozary A. A case report: accessory right renal artery. International Journal of Anatomical Variations. 2009;2:119-121.
2. Gupta V, Kotgirwar S, Trivedi S, Deopujar R, Singh V. Bilateral variations in renal vasculature. International Journal of Anatomical Variations. 2010; 3: 53-55.
3. Bordei P, Sapte E, Iliescu D. Double renal arteries originating from the aorta. Surg Radiol Anat. 2004;26(6):474-479.
4. Keibel F, Mall FP. Manual of Human Embryology. Philedelphia: Lippincott, 1912;655.
5. Sampaio FJ,Passos MA. Renal arteries: anatomic study for surgical and radiological practice. Surg Radiol Anat. 1992;14(2):113-117.
6. Ozkan U, Oguzkurt L, Tercan F, Kizilkiliç O, KoçZ, Koca N. Renal artery origins and variations: angiographic evaluation of 855 consecutive patients. Diagn Interv Radiol.2006; 12(4):183-186.
7. Ragiba Zagyapan, Can P, Kurkcuoglu A. A retrospective study on multiple renal arteries in Turkish population. Internation Journal of Experimental and Clinical Anatomy.2009;3: 35-39.
8. Fernandes RMP, Conte FHP, Favorito LA, Abidu-Figueiredo M, Babinski MA. Triple Right Renal Vein: An Uncommon Variation. Int J Morphol.2005;2(3):231-233.

9. Standring S. Gray’s Anatomy. Regional Anatomy: Posterior Abdominal Region. In: Susan Standring editor. 39th edition. London, Elsevier Churchill Livingstone, 2005; 324-326.
10. Kadir S. Atlas of Normal and Variant Angiographic Anatomy. Kidneys. In: Saadoon Kadir, Michael F. Brothers editor. 1st edition. Philedelphia, W.B. Saunders Company, 1991; 387-428.
11. Shashikala P, Anjali W, Anshuman N, Jayshree D. A case report: double renal arteries. International Journal of Anatomical Variations.2012;5:22-24.
12. Sancak B, Deva E, Özkul E, Zagyapan R. Multiple renal arterler. Hacettepe Tıp Cerrahi Bülteni.1980;13:283-289.
13. Langman J, Sadler TW. Embryologie Médicale. Système cardiovasculaire. In: Robert Pagés editor. 6th edition. Paris, Pradel, 1996;301.
14. Madhyastha S, Suresh R, Rao R. Multiple variations of renal vessels and ureter. Indian Journal of Urology.2001;17(2):164-165.
15. Awojobi OA, Ogunbiyi OA, Nkposong EO.Unusual relationship of multiple renal arteries. Urology.1983;21(2):205-206.
16. Cicekcibasi, AE, Ziylan T, Salbacak A, Seker M, Buyukmumcu M, Tuncer I. An investigation of the origin, location and variations of the renal arteries in human fetuses and their clinical relevance. Ann Anat.2005;187(4):421-427.
17. Moar JJ, Tobias PV. Multiple renal arteries. S Afr Med J. 1985;67(11):399.
18. Novick AC, Magnusson M, Braun WE. Multiple-artery renal transplantation: emphasis on extracorporeal methods of donor arterial reconstruction. J Urol. 1979;122(6):731-735.
19. Ashken MH.A study of the renal vascular patterns in hypertension, chronic pyelonephritis and other diseases. Hunterian Lecture delivered at the Royal College of Surgeons of England on 24th February 1966. Ann R Coll Surg Engl.1967;40(2):82-99.
20. Bergman RA, Cassell MD, Sahinoglu K, Heidger PM. Human doubled renal and testicular arteries. Ann Anat.1992;174(4):313-315.
21. Bulic K, Ivkic G, Pavic T. A case of duplicated right renal artery and triplicated left renal artery. Ann Anat. 1996;178(3):281-283.
22. Sarfraz R, Tahir M, Sami W. Presegmental Arterial Pattern of Human Kidneys in Local Populatio. Ann Pak Inst Med Sci.2008;4(4):212-215.
23. Daescu E, Zahoi DE, Motoç A, Alexa A, Baderca F, Enache A.Morphological variability of the renal artery branching pattern: a brief review and an anatomical study. Rom J Morphol Embryol.2012;53(2):287-291.
24. Budhiraja V, Rastogi R, Jain V, Bankwar V. Anatomical variations of renal artery and its clinical correlations: a cadaveric study from central India. J. Morphol. Sci.2012;30(4):228-233.
25. Satyapal KS, Haffejee AA, Singh B, Ramsaroop L, Robbs JV, Kalideen JM. Additional renal arteries: incidence and morphometry. Surg Radiol Anat.2001;23:33-38.
26. Emiroglu R, Koseoglu F, Karakayali H, Bilgin N, Haberal M.Multiple-artery anastomosis in kidney transplantation. Transplant Proc.2000;32(3):617-619.