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Song WH, Baik J, Choi EK, Lee HY, Kim HH, Park SM, Jeong CW. Quantitative analysis of renal arterial variations affecting the eligibility of catheter-based renal denervation using multi-detector computed tomography angiography. Sci Rep 2020; 10:19720. [PMID: 33184427 PMCID: PMC7665003 DOI: 10.1038/s41598-020-76812-w] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2020] [Accepted: 09/25/2020] [Indexed: 11/09/2022] Open
Abstract
Catheter-based renal denervation (RDN) was introduced to treat resistant hypertension. However, the reduction in blood pressure after the RDN was modest. Catheter-based RDN was performed only at main renal arteries, except for accessory and branch arteries due to the diameter being too small for the catheter to approach. Here, we retrospectively analyzed the anatomy of diverse renal arteries via 64-channel multi-detector computed tomography angiograms of 314 consecutive donors who underwent living donor nephrectomy from January 2012 to July 2017. Occurrence rates of one or more accessory renal arteries in donors were 25.3% and 19.4% on the left and right sides, respectively. Early branching rates before 25 mm from the aorta to the right and left renal arteries were 13.7% and 10.5%, respectively. Overall, 63.1% and 78.3% of donors had no accessory artery bilaterally and no branched renal artery, respectively. As a result, 47.1% had only main renal arteries without an accessory artery and early-branching artery. Approximately half of the donors had multiple small renal arteries bilaterally, for which catheter-based denervation may not be suitable. Thus, preoperative computed tomography angiography requires careful attention to patient selection, and there is a need for improved methods for denervation at various renal arteries.
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Affiliation(s)
- Won Hoon Song
- Department of Urology, Seoul National University Hospital, 101, Daehak-ro, Jongno-gu, Seoul, 03080, Republic of Korea.,Department of Urology, Pusan National University Yangsan Hospital, Yangsan, Republic of Korea
| | - Jinhwan Baik
- Department of Creative IT Engineering, Pohang University of Science and Technology (POSTECH), 77 Cheongam-Ro, Nam-Gu, Pohang, Gyeongbuk, 37673, Republic of Korea
| | - Eue-Keun Choi
- Department of Internal Medicine, Seoul National University Hospital, Seoul, Republic of Korea
| | - Hae-Young Lee
- Department of Internal Medicine, Seoul National University Hospital, Seoul, Republic of Korea
| | - Hyeon Hoe Kim
- Department of Urology, Seoul National University Hospital, 101, Daehak-ro, Jongno-gu, Seoul, 03080, Republic of Korea
| | - Sung-Min Park
- Department of Creative IT Engineering, Pohang University of Science and Technology (POSTECH), 77 Cheongam-Ro, Nam-Gu, Pohang, Gyeongbuk, 37673, Republic of Korea.
| | - Chang Wook Jeong
- Department of Urology, Seoul National University Hospital, 101, Daehak-ro, Jongno-gu, Seoul, 03080, Republic of Korea.
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Anatomical variants of renal veins: A meta-analysis of prevalence. Sci Rep 2019; 9:10802. [PMID: 31346244 PMCID: PMC6658480 DOI: 10.1038/s41598-019-47280-8] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2018] [Accepted: 07/15/2019] [Indexed: 11/22/2022] Open
Abstract
The main aim of this article is to establish the actual prevalence of renal vein variations (circumaortic renal vein, retroaortic renal vein, double renal vein), and to increase awareness about them. To this purpose, we have performed a meta-analysis of prevalence, using the MetaXL package, We included 105 articles in the final analysis of prevalence, of which 88 contained data about retroaortic renal vein, 84 – about circumaortic renal vein, and 51 - about multiple renal veins. The overall prevalence for retroaortic renal vein was 3% (CI:2.4–3.6%), for circumaortic renal vein − 3.5% (CI:2.8–4.4%), and for multiple renal veins - 16.7% (14.3–19.2%), much higher on the right 16.6 (14.2–19.1%) than on the left side 2.1 (1.3–3.2%). The results were relatively homogenous between studies, with only a minor publication bias overall.
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Motoyama D, Ishii Y, Takehara Y, Sugiyama M, Yang W, Nasu H, Ushio T, Hirose Y, Ohishi N, Wakayama T, Kabasawa H, Johnson K, Wieben O, Sakahara H, Ozono S. Four-dimensional phase-contrast vastly undersampled isotropic projection reconstruction (4D PC-VIPR) MR evaluation of the renal arteries in transplant recipients: Preliminary results. J Magn Reson Imaging 2017; 46:595-603. [DOI: 10.1002/jmri.25607] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2016] [Accepted: 12/05/2016] [Indexed: 11/11/2022] Open
Affiliation(s)
- Daisuke Motoyama
- Department of Urology; Hamamatsu University School of Medicine; Shizuoka Japan
| | - Yasuo Ishii
- Department of Surgery; Kidney Center, Toranomon Hospital; Tokyo Japan
| | - Yasuo Takehara
- Department of Fundamental Development for Advanced Low Invasive Diagnostic Imaging; Nagoya University, Graduate School of Medicine; Nagoya Japan
| | - Masataka Sugiyama
- Department of Diagnostic Radiology & Nuclear Medicine; Hamamatsu University School of Medicine; Shizuoka Japan
| | - Wang Yang
- Department of Diagnostic Radiology & Nuclear Medicine; Hamamatsu University School of Medicine; Shizuoka Japan
| | - Hatsuko Nasu
- Department of Diagnostic Radiology & Nuclear Medicine; Hamamatsu University School of Medicine; Shizuoka Japan
| | - Takasuke Ushio
- Department of Diagnostic Radiology & Nuclear Medicine; Hamamatsu University School of Medicine; Shizuoka Japan
| | - Yuko Hirose
- Department of Diagnostic Radiology & Nuclear Medicine; Hamamatsu University School of Medicine; Shizuoka Japan
| | - Naoki Ohishi
- Department of Radiology; Hamamatsu University Hospital; Shizuoka Japan
| | - Tetsuya Wakayama
- Applied Science Laboratory Asia Pacific, GE Healthcare Japan; Tokyo Japan
| | - Hiroyuki Kabasawa
- Department of Medical Physics and Radiology; University of Wisconsin School of Medicine and Public Health; Madison Wisconsin USA
| | - Kevin Johnson
- Department of Medical Physics and Radiology; University of Wisconsin School of Medicine and Public Health; Madison Wisconsin USA
| | - Oliver Wieben
- Department of Medical Physics and Radiology; University of Wisconsin School of Medicine and Public Health; Madison Wisconsin USA
| | - Harumi Sakahara
- Department of Diagnostic Radiology & Nuclear Medicine; Hamamatsu University School of Medicine; Shizuoka Japan
| | - Seiichiro Ozono
- Department of Urology; Hamamatsu University School of Medicine; Shizuoka Japan
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Utility of MRI in the Characterization of Indeterminate Small Renal Lesions Previously Seen on Screening CT Scans of Potential Renal Donor Patients. AJR Am J Roentgenol 2015. [PMID: 26204282 DOI: 10.2214/ajr.14.13956] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
OBJECTIVE The purpose of this study was to determine whether MRI could more confidently characterize indeterminate small renal lesions (< 15 mm) previously seen on CT scans of potential renal donor patients and whether such characterization could impact surgical management and donor candidate status. MATERIALS AND METHODS After dedicated contrast-enhanced renal CT examinations of a population of renal donor patients identified indeterminate small renal lesions (< 15 mm), dedicated renal MRI examinations were performed for 55 of those patients. Two radiologists used consensus reading of established MRI characteristics to characterize indeterminate small lesions as simple cysts, hemorrhagic cysts, angiomyolipomas, or solid renal masses. RESULTS A total of 94 indeterminate small renal lesions were detected on CT. MRI was able to confidently diagnose 93 of those lesions, including 83 cysts, eight hemorrhagic cysts, and two angiomyolipomas. MRI directly affected the surgical management of four of the patients (7%). CONCLUSION For potential renal donor patients, MRI can be an effective means of characterizing lesions that are deemed to be too small to characterize by CT. MRI can also potentially alter the surgical management and donor status of this group of patients.
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Ibrahim G, Yamp İlmaz MT, Keskin S, Aramp İbas A, Akamp İn D, Akcan M, Salbacak A. Two vascular variations in one patient of the hepatogastric trunk and retro-aortic left renal vein. Qatar Med J 2013; 2013:41-4. [PMID: 25003064 PMCID: PMC4080491 DOI: 10.5339/qmj.2013.15] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2013] [Accepted: 12/15/2013] [Indexed: 11/03/2022] Open
Abstract
This study reports the case of a 61-year-old man with right upper quadrant pain who underwent abdominal computed tomography examination. A solid lesion originating from the biliary tract was detected on the images. While evaluating the vascular structures, the splenic artery was seen to directly originate from the abdominal aorta. Retro-aortic left renal vein was also seen on computerised tomography. Splenic artery originating from the abdominal aorta is a rare variation. The retro-aortic left renal vein is a malformation characterized by the presence of a vessel that drains the left renal blood up to the inferior vena cava crossing behind the aortic artery. Such anatomical variations are important for surgeons to be aware of.
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Affiliation(s)
- Guler Ibrahim
- Meram Faculty of Medicine, Necmettin Erbakan University, Turkey
| | | | - Suat Keskin
- Meram Faculty of Medicine, Necmettin Erbakan University, Turkey
| | | | - Dondu Akamp İn
- Meram Faculty of Medicine, Necmettin Erbakan University, Turkey
| | - Mustafa Akcan
- Meram Faculty of Medicine, Necmettin Erbakan University, Turkey
| | - Ahmet Salbacak
- Meram Faculty of Medicine, Necmettin Erbakan University, Turkey
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The three most common variations of the left renal vein: a review and meta-analysis. Surg Radiol Anat 2012; 34:799-804. [DOI: 10.1007/s00276-012-0968-1] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2011] [Accepted: 03/24/2012] [Indexed: 10/28/2022]
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