Renal artery variations with clinical significance: Multiple renal arteries and their coexistent anatomical abnormalities: A cadaveric study

Year 2024, , 46 - 54, 31.08.2024

Hürriyet Ercan Çetinok

https://doi.org/10.35514/mtd.2024.111

Abstract

Purpose: This cadaveric study aimed to identify the multiple renal arteries and evaluate their association with other anatomical abnormalities. The possible clinical consequences of more than one renal artery were analyzed.
Material - methods: This study was carried out by accessing the Abdominal aorta (AA) of 20 American cadavers [12 males, 8 females, ages 50-96] donated to the C&DA Department of Albert Einstein College of Medicine. From the cadavers in the supine position, the branch points of the renal artery from the abdominal aorta on the right and left sides were checked to see if there was more than one. Renal artery (left side), celiac trunk, superior mesenteric artery, inferior mesenteric artery, and aortic bifurcation were measured in 3 ways: linear, longitudinal, and transverse. The obtained results were assessed using a comparative analysis with earlier research findings documented in the literature.

Results: Among the 20 cadavers included in the study, two males, aged 62 and 80, were found to have two renal arteries on the right side, and both of them are hiler arteries. These multiple renal arteries were coexistent with splenomegaly, tortuosity of the abdominal aorta, and deviation of the vertebral column at the level of the 3rd lumbar vertebra. 94.7% of the cadavers exhibited normal renal arterial anatomy. The most common branching locations of the main renal arteries and multiple renal arteries (MRA) were found find from the abdominal aorta.


Conclusion: Before surgical or radiological procedures in the anatomical region related to and adjacent to renal arteries, knowing the possible renal artery variations in the anatomy of the region is very important to reduce mortality and morbidity during surgical or interventional procedures. Knowing the anatomy of renal arteries and evaluating it radiologically will guide renal transplantation, hepatorenal surgery, interventional radiology, and nephrology the prevention and treatment of many conditions, such as hypertension, and target organ damage.

Keywords

Multiple renal arteries, Renal artery variations, Accessory renal arteries

Ethical Statement

In this study, ethical approval is not required since the study is based on course cadavers from Albert Einstein College of Medicine C&DA Department according to the exemption categories in Enstein-IRB-citation104(d).

Supporting Institution

Albert Eistein College of Medicine, C&DA Department,

Thanks

I would like to express my endless gratitude to all the donors who donated their bodies for education and science in this study and to the AECOM team.

Klinik önemi olan renal arter varyasyonları: Çoklu renal arterler ve eşlik eden anatomik varyasyonlar: Bir kadavra çalışması

Abstract

Amaç: Bu kadavra çalışmasının amacı multipl renal arterleri tanımlamak ve aynı zamanda diğer anatomik anormallikler ile birlikteliğini değerlendirmekti. Birden fazla arteria renalis’in bulunmasının olası klinik sonuçları analiz edildi.

Metod: Bu çalışma, Albert Einstein College of Medicine C&DA Anabilim Dalı’na bağışlanan 20 Amerikan kadavrasından [12 erkek, 8 kadın, yaşları 50-96] Aorta Abdominalis(AA)’e ulaşılarak gerçekleştirildi. Supin pozisyondaki kadavralardan Arteria renalis’in sağ ve sol tarafta Aorta abdominalis’ten dallanma noktaları, birden fazla sayıda olup olmadıkları kontrol edildi. Arteria renalis(sol taraf), Truıncus coeliacus, arteria(a.) mesenterica superior, a. mesenterica inferior, bifurcatio aorta arasındaki mesafeler, lineer, longitudinal ve transvers olmak üzere 3 şekilde ölçüldü. Elde edilen sonuçlar oranlanarak, lieratürdeki önceki çalışmalarla kıyaslanarak değerlendirildi.

Bulgular: Çalışmaya alınan 20 kadavradan 62 ve 80 yaşında olan iki erkek cinsiyette, ikiside hiler arter olmak üzere sağ tarafta iki adet renal arter olduğu tespit edildi. Multiple renal arterlere, splenomagali, abdominal aorta da ondülan seyir, 3. Lumbal vertebra seviyesinde columna vertebralis’te deviasyon olduğu gözlendi. Hastaların %94,7'si normal renal arter anatomisine sahipti. Ana renal arterlerin ve ARA'nın en sık Aorta abdominalis’ten dallanıyordu.

Sonuç: Arteria renalis ile ilişkili ve komşuluğundaki Anatomik bölgedeki cerrahi veya radyolojik işlemler öncesinde bölge Anatomisindeki olası arteria renalis varyasyonlarının bilinmesi cerrahi veya girişimsel işlemler sırasındaki mortalite ve morbiditeyi azaltmakta çok önemlidir. Renal transplantasyon ve Hepatorenal cerrahi, girişimsel radyoloji, nefroloji başta olmak üzere A.(arteria) renalis anatomisinin bilinerek, radyolojik olarak değerlendirilmesi, hipertansiyon, hedef organ hasarı gibi pek çok kliniğin önlenmesi ve tedavisine kılavuz olacaktır.

Keywords

Multiple arteria renalis, aksesuar renal arterler, arteria renalis varyasyonları

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