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Mohammed S, AbdAlla E, Elhag A, El-Mardi A. The prevalence of accessory renal arteries in sudanese population in Khartoum State: a cross-sectional CT study from 2017 to 2020. BMC Nephrol 2024; 25:135. [PMID: 38622526 PMCID: PMC11017523 DOI: 10.1186/s12882-024-03573-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/29/2024] [Accepted: 04/08/2024] [Indexed: 04/17/2024] Open
Abstract
BACKGROUND Renal artery variations are clinically significant due to their implications for surgical procedures and renal function. However, data on these variations in Sudanese populations are limited. This study aimed to determine the prevalence and characteristics of renal artery variations in a Sudanese population. METHODS A cross-sectional retrospective study was conducted in Khartoum state from October 2017 to October 2020. A total of 400 Sudanese participants who underwent abdominal CT scans were included. Data on demographic characteristics, kidney measurements, and renal vasculature were collected and analyzed using descriptive statistics and inferential tests. RESULTS The mean age of participants was 46.7 ± 18 years, with a nearly equal gender distribution. Overall, renal artery variations were present in 11% of participants, with accessory renal arteries observed in 6% of the study population. Among those with accessory vessels, 50% were on the right side, 29.2% on the left, and 20.8% bilateral, distributed across hilar 29.2%, lower polar 29.2%, and upper polar 41.7% regions. No significant associations were found between accessory renal arteries and age or gender (p-value > 0.05). However, participants with accessory renal arteries exhibited significantly narrower width 5.0 ± 1.4 than those with no with accessory renal arteries 5.8 ± 1.1 (p-value 0.002) Early dividing renal arteries were found in 5% of participants, with nearly half being bilateral. No significant associations were found between the presence of early dividing renal arteries and demographic or renal measurements (p-value > 0.05). CONCLUSION This study provides valuable insights into the prevalence and characteristics of renal artery variations in a Sudanese population. The findings contribute to our understanding of renal anatomy in this demographic and can inform clinical practice and surgical planning, particularly in renal transplantation and other renal procedures.
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Affiliation(s)
- Safaa Mohammed
- Nursing Department, Faculty of Medical Sciences and Nursing, Alrayan Colleges, Almadina, Saudi Arabia
| | - Eltayeb AbdAlla
- Faculty of Medicine, University of Khartoum, Khartoum, Sudan.
| | - Amal Elhag
- Assistant Professor of Human Anatomy, Faculty of Medicine and Surgery, Umm Al-Qura University, Makkah, Saudi Arabia
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2
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Wu F, Yuan X, Sun K, Zhang Y, Zhu L, Bai C, Cheng Y, Lu Y, Jiang Y, Song W. Effect of Accessory Renal Arteries on Essential Hypertension and Related Mechanisms. J Am Heart Assoc 2024; 13:e030427. [PMID: 38348775 PMCID: PMC11010091 DOI: 10.1161/jaha.123.030427] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/08/2023] [Accepted: 12/21/2023] [Indexed: 02/21/2024]
Abstract
BACKGROUND This case-control study aimed to determine whether there were differences between patients with essential hypertension with accessory renal arteries (ARAs) and those without ARAs. METHODS AND RESULTS The enrolled patients with essential hypertension were divided into the ARA group (n=200) and control group without ARAs (n=238). After propensity matching, 394 patients (197 in each of the 2 groups), were included. The 24-hour BP (4.33/2.43 mm Hg) and daytime BP (4.48/2.61 mm Hg) of patients in the ARA group were significantly higher than those of the control group (P<0.05). The flow-mediated dilation was lower in the ARA group (5.98±2.70 versus 5.18±2.66; P<0.05). In correlation analysis, the horizontal plasma aldosterone concentration had the highest correlation with 24-hour, daytime, and nighttime systolic BP (r=0.263, 0.247, and 0.243, respectively; P<0.05) and diastolic BP (r=0.325, 0.298, and 0.317, respectively; P<0.05). As for multivariate regression analysis, plasma aldosterone concentration was a significant risk factor for elevated 24-hour, daytime, and nighttime systolic BP (β=0.249 [95% CI, 0.150-0.349], 0.228 [95% CI, 0.128-0.329], and 0.282 [95% CI, 0.187-0.377], respectively; P<0.05) and elevated diastolic BP (β=0.289 [95% CI, 0.192-0.385], 0.256 [95% CI, 0.158-0.353], and 0.335 [95% CI, 0.243-0.427], respectively; P<0.05). Direct renin concentration was also a risk factor for 24-hour and daytime BPs, whereas heart rate was a risk factor correlated with 24-hour, daytime, and nighttime diastolic BP (all P<0.05). For the mixed-effects model for repeated measures, the results were similar to results of the multivariate regression analysis (all P<0.05). CONCLUSIONS ARAs could contribute a higher BP of patients with essential hypertension and might promote the development of essential hypertension. The mechanism might be related to overactivation of the renin-angiotensin-aldosterone system and sympathetic nervous system.
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Affiliation(s)
- Fengyuan Wu
- Department of CardiologyFirst Affiliated Hospital of Dalian Medical UniversityDalianLiaoningChina
| | - Xiaoyang Yuan
- Department of Clinical LaboratoryFirst Affiliated Hospital of Dalian Medical UniversityDalianLiaoningChina
| | - Kaiwen Sun
- Department of CardiologyFirst Affiliated Hospital of Dalian Medical UniversityDalianLiaoningChina
| | - Ying Zhang
- Department of CardiologyFirst Affiliated Hospital of Dalian Medical UniversityDalianLiaoningChina
| | - Lianxin Zhu
- Department of CardiologyFirst Affiliated Hospital of Dalian Medical UniversityDalianLiaoningChina
| | - Cuiping Bai
- Department of CardiologyFirst Affiliated Hospital of Dalian Medical UniversityDalianLiaoningChina
| | - Yunpeng Cheng
- Department of CardiologyFirst Affiliated Hospital of Dalian Medical UniversityDalianLiaoningChina
| | - Yan Lu
- Department of CardiologyFirst Affiliated Hospital of Dalian Medical UniversityDalianLiaoningChina
| | - Yinong Jiang
- Department of CardiologyFirst Affiliated Hospital of Dalian Medical UniversityDalianLiaoningChina
| | - Wei Song
- Department of CardiologyFirst Affiliated Hospital of Dalian Medical UniversityDalianLiaoningChina
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Kovačević N, Hočevar M, Vivod G, Merlo S. Vascular and Urinary Tract Anatomic Variants Relevant to Para-Aortic Lymphadenectomy in Women with Gynecological Cancers. Cancers (Basel) 2023; 15:4959. [PMID: 37894326 PMCID: PMC10605252 DOI: 10.3390/cancers15204959] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2023] [Revised: 10/08/2023] [Accepted: 10/10/2023] [Indexed: 10/29/2023] Open
Abstract
BACKGROUND Para-aortic lymphadenectomy is an essential part of gynecologic oncologic surgical treatment. The surgeon should be aware of the complex usual anatomy and its common variants. METHODS Between January 2021 and May 2023, 58 women underwent para-aortic lymphadenectomy for gynecologic malignancies. RESULTS Vascular and urinary tract anatomic variants were retrospectively reviewed from the prospective institutional database and results were compared with preoperative contrast-enhanced abdominal CT. Of these 58 women, 47 women had no vascular or urinary tract variants. One woman had a double inferior vena cava, two patients were found to have a retro-aortic left renal vein, four had accessory renal arteries, two had a double left ureter, one had a ptotic kidney in the iliac fossa, and one patient had bilateral kidney malrotation. Anatomic variants in the preoperative CT were described by a radiologist in only two patients, and additional vascular and urinary tract variants were found incidentally at the time of surgery. CONCLUSIONS Acknowledgment of vascular and urinary tract variants is helpful for the surgeon to establish an appropriate surgical plan and to avoid iatrogenic surgical trauma.
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Affiliation(s)
- Nina Kovačević
- Department of Gynecological Oncology, Institute of Oncology Ljubljana, 1000 Ljubljana, Slovenia; (N.K.); (M.H.); (G.V.)
- Faculty of Medicine, University of Ljubljana, Zaloška cesta 2, 1000 Ljubljana, Slovenia
- Faculty of Health Care Angela Boškin, Spodnji Plavž 3, 4270 Jesenice, Slovenia
| | - Marko Hočevar
- Department of Gynecological Oncology, Institute of Oncology Ljubljana, 1000 Ljubljana, Slovenia; (N.K.); (M.H.); (G.V.)
- Faculty of Medicine, University of Ljubljana, Zaloška cesta 2, 1000 Ljubljana, Slovenia
| | - Gregor Vivod
- Department of Gynecological Oncology, Institute of Oncology Ljubljana, 1000 Ljubljana, Slovenia; (N.K.); (M.H.); (G.V.)
- Faculty of Medicine, University of Ljubljana, Zaloška cesta 2, 1000 Ljubljana, Slovenia
| | - Sebastjan Merlo
- Department of Gynecological Oncology, Institute of Oncology Ljubljana, 1000 Ljubljana, Slovenia; (N.K.); (M.H.); (G.V.)
- Faculty of Medicine, University of Ljubljana, Zaloška cesta 2, 1000 Ljubljana, Slovenia
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4
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Kasprzycki K, Petkow-Dimitrow P, Krawczyk-Ożóg A, Bartuś S, Rajtar-Salwa R. Anatomic Variations of Renal Arteries as an Important Factor in the Effectiveness of Renal Denervation in Resistant Hypertension. J Cardiovasc Dev Dis 2023; 10:371. [PMID: 37754800 PMCID: PMC10531508 DOI: 10.3390/jcdd10090371] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2023] [Revised: 08/20/2023] [Accepted: 08/23/2023] [Indexed: 09/28/2023] Open
Abstract
Hypertension remains the leading cause of death worldwide. Despite advances in drug-based treatment, many patients do not achieve target blood pressure. In recent years, there has been an increased interest in invasive hypertension treatment methods. Long-term effects and factors affecting renal denervation effectiveness are still under investigation. Some investigators found that the renal arteries' morphology is crucial in renal denervation effectiveness. Accessory renal arteries occur in 20-30% of the population and even more frequently in patients with resistant hypertension. Diversity in renal vascularization and innervation may complicate the renal denervation procedure and increase the number of people who will not benefit from treatment. Based on previous studies, it has been shown that the presence of accessory renal arteries, and in particular, the lack of their complete denervation, reduces the procedure's effectiveness. The following review presents the anatomical assessment of the renal arteries, emphasizing the importance of imaging tests. Examples of imaging and denervation methods to optimize the procedure are presented. The development of new-generation catheters and the advancement in knowledge of renal arteries anatomy may improve the effectiveness of treatment and reduce the number of patients who do not respond to treatment.
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Affiliation(s)
- Karol Kasprzycki
- Department of Cardiology and Cardiovascular Interventions, University Hospital, 30-688 Krakow, Poland
| | - Paweł Petkow-Dimitrow
- Department of Cardiology and Cardiovascular Interventions, University Hospital, 30-688 Krakow, Poland
- 2nd Department of Cardiology, Jagiellonian University Medical College, 30-688 Krakow, Poland
| | - Agata Krawczyk-Ożóg
- Department of Cardiology and Cardiovascular Interventions, University Hospital, 30-688 Krakow, Poland
- Department of Anatomy, Jagiellonian University Medical College, 33-332 Krakow, Poland
| | - Stanisław Bartuś
- Department of Cardiology and Cardiovascular Interventions, University Hospital, 30-688 Krakow, Poland
- 2nd Department of Cardiology, Jagiellonian University Medical College, 30-688 Krakow, Poland
| | - Renata Rajtar-Salwa
- Department of Cardiology and Cardiovascular Interventions, University Hospital, 30-688 Krakow, Poland
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Sanyal S, Chunilall G, Uzoekwe GO, Taylor EP. Artificial Urinary Sphincter With Bilateral Atrophic Kidneys and Accessory Renal Arteries in a Male Cadaveric Subject: A Case Report and Clinicopathological Reconciliation of Urinary Abnormalities and Embryogenetic Correlation of Vascular Aberrations. Cureus 2023; 15:e37948. [PMID: 37220469 PMCID: PMC10200279 DOI: 10.7759/cureus.37948] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/21/2023] [Indexed: 05/25/2023] Open
Abstract
A unique combination of triple abnormality in a willed male body donor dissection, with putative clinicopathological correlations during the subject's lifetime, is described in this case report. The subject had a three-piece artificial urinary sphincter surgically implanted around the proximal corpus spongiosum, left scrotal pouch and in the lower left abdominal wall, ostensibly for urinary incontinence during his lifetime, though the etiology of the latter was not immediately obvious. He also had a total of three accessory renal arteries involving both sides, complicated by bilateral diffuse renal atrophy from presumable glomerulosclerosis or nephrosclerosis-induced nephrotic syndrome. While each entity may not be so unique per se, each is not too common either. The combination of all three findings has not been described to date in the contemporary literature in a single male cadaver dissection. Only seven reports of artificial urinary sphincter studies on human cadaver subjects could be detected in contemporary literature, this being the eighth. Finally, there were no apparent etiopathological or pathogenetic mechanisms to explain the occurrence of each or the coexistence of all of them in a single male cadaveric subject. The artificial urinary sphincter was reviewed with respect to its characteristics, placement, and efficacy. An attempt was made to establish the cause-effect relationship between the artificial sphincter and urinary incontinence that necessitated the implant. Thereafter, a clinicopathological correlation was proposed in this case report to reconcile the concomitance of urinary incontinence, bilateral accessory renal arteries, and bilateral renal atrophy. An embryogenetic mechanism of the aberrant renal arteries was also suggested. Physician awareness from the standpoint of preoperative investigation of such cases was also highlighted.
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Affiliation(s)
- Sanjoy Sanyal
- Surgical Anatomy, Richmond Gabriel University College of Medicine, Belair, VCT
- Academic Affairs, Richmond Gabriel University, Belair, VCT
| | - Gomattie Chunilall
- Medical Education and Simulation, Richmond Gabriel University College of Medicine, Belair, VCT
| | - Ginikachukwu O Uzoekwe
- Medicine, Richmond Gabriel University, Belair, VCT
- General Surgery, Maypen General Hospital, Clarendon, JAM
| | - Edward Peter Taylor
- Internal Medicine, Richmond Gabriel University College of Medicine, Belair, VCT
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Mihaylova E, Groudeva V, Nedevska M. Multidetector computed tomography angiography study of the renal arterial vasculature anatomy and its variations in a Bulgarian adult population. Surg Radiol Anat 2023; 45:289-296. [PMID: 36729216 DOI: 10.1007/s00276-023-03092-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2022] [Accepted: 01/23/2023] [Indexed: 02/03/2023]
Abstract
PURPOSE Renal arterial anatomy has a great clinical importance during surgical and endovascular procedures. However, comprehensive data on renal arterial variations in the Bulgarian population has not yet been provided. The aim of this study was to conduct a detailed research about the normal anatomy and variations of the renal arteries in the Bulgarian population. METHODS Five hundred sixty-one patients underwent contrast-enhanced multidetector computed tomography scans for the period 2016-2021. The images were retrospectively reviewed. Number, branching pattern, origin level and course of the renal arteries were noted. Data were categorized on the basis of laterality, gender and symmetry. RESULTS Only 46.3% of the patients exhibited normal renal arterial anatomy. Variations were observed in 301 patients (53.7%). The most common variant was the presence of accessory renal arteries (ARA), discovered in 41.2% of the subjects. There was no significant difference based on gender and laterality (p > 0.05). Hilar ARA (72.6%) were significantly more common than polar ARA (p < 0.001). The most common origin location of the main renal arteries and ARA was the aorta, followed by the common iliac arteries. Early division was observed in 21.7% of the patients, significantly more common on the right. Precaval course was found in 0.5% of the right main renal arteries and in 30% of ARA and the difference was significant (p < 0.001). CONCLUSION These results show novel insight into the prevalence of renal arterial variations in the Bulgarian population. Anatomic renal vasculature variants are common therefore awareness is crucial for the success of surgical and interventional procedures.
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Affiliation(s)
- Evgeniya Mihaylova
- Department of Radiology, Prof. Dr. Alexander Chirkov University Hospital, Pencho Slaveykov Blvd, 1431 52A, Sofia, Bulgaria.
- Department of Radiology, Medical University Sofia, Sofia, Bulgaria.
| | - Violeta Groudeva
- Department of Radiology, Prof. Dr. Alexander Chirkov University Hospital, Pencho Slaveykov Blvd, 1431 52A, Sofia, Bulgaria
- Department of Radiology, Medical University Sofia, Sofia, Bulgaria
| | - Maria Nedevska
- Department of Radiology, Prof. Dr. Alexander Chirkov University Hospital, Pencho Slaveykov Blvd, 1431 52A, Sofia, Bulgaria
- Department of Radiology, Medical University Sofia, Sofia, Bulgaria
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7
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Muacevic A, Adler JR. Wunderlich Syndrome: Spontaneous Cystic Rupture on Account of Acquired Kidney Atrophy. Cureus 2022; 14:e30386. [PMID: 36407245 PMCID: PMC9668205 DOI: 10.7759/cureus.30386] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/17/2022] [Indexed: 01/25/2023] Open
Abstract
Wunderlich syndrome is an uncommon condition of spontaneous subcapsular and perirenal hemorrhage of atraumatic etiology in the kidney, with the potential to spread to the retroperitoneal region beyond the perirenal fascias. Its clinical manifestations usually include Lenk's triad, namely, acute flank pain, flank mass, and hemodynamic instability, which vary depending on the causative underlying renal pathology. Tumor bleeding of benign and malignant renal neoplasms is the most common cause of this syndrome, followed by vascular disorders and renal cystic diseases. Here, we report the case of a unilateral subcapsular renal hematoma on account of a left atrophic kidney with parapelvic cystic formations and variant hypoplastic vasculature which was successfully managed via radical nephrectomy after initial conservative treatment. Spontaneous cystic rupture contributed to the emergence of the syndrome, and its mechanisms are being addressed.
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8
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Kim J, Lee JM, Cho SG, Hong JU. Ectopic vascularization of the right kidney arising from contralateral common iliac artery. SURGICAL AND RADIOLOGIC ANATOMY : SRA 2022; 44:979-981. [PMID: 35771276 DOI: 10.1007/s00276-022-02970-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/12/2021] [Accepted: 06/02/2022] [Indexed: 12/01/2022]
Abstract
BACKGROUND Variant renal arteries have been reported in 20~30% of the entire population. The anatomic variations among advanced patients should be investigated when performing surgery or interventional procedures on the kidney. Most variant renal arteries originated from various level of the abdominal aorta. Very rarely, this case shows renal artery originated from the contralateral common iliac artery with other accessory arteries. CASE PRESENTATION MDCT angiography revealed several anatomical variants of the right kidney. There were four right renal arteries. The main renal artery originated from the left proximal common iliac artery and other renal artery originated from the aortic bifurcation. The other two renal arteries arose from the abdominal aorta, lower thoracic T12 level and lower lumbar L4 level. The right kidney was located at the level of the third to fifth lumbar vertebra. And renal pelvis of the right kidney was laterally rotated. CONCLUSION This case documented a rare anatomic variant, involving multiple accessory renal arteries, including the main artery originating from the contralateral iliac artery, caused by a specific renal embryological condition. These variants should be analysed to effectively perform surgical and interventional procedures.
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Affiliation(s)
- Jeongkyeom Kim
- Department of Radiology, Inha University Hospital, Incheon, 22332, South Korea
| | - Jeong-Min Lee
- Department of Radiology, Inha University Hospital, Incheon, 22332, South Korea.
| | - Soon Gu Cho
- Department of Radiology, Inha University Hospital, Incheon, 22332, South Korea
| | - Jung Ui Hong
- Department of Radiology, Inha University Hospital, Incheon, 22332, South Korea
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9
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Farahzadi A, Mahmoodzadeh H, Gopal N. A solitary precaval right renal artery: A case report. Clin Case Rep 2022; 10:e05866. [PMID: 35662777 PMCID: PMC9163477 DOI: 10.1002/ccr3.5866] [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: 03/30/2022] [Revised: 04/28/2022] [Accepted: 04/29/2022] [Indexed: 11/05/2022] Open
Abstract
Knowledge of aberrant renal vasculature is critical for preoperative planning of either open or minimally invasive renal surgery. A precaval right renal artery is a rare anatomical variant in which the artery passes anterior to the inferior vena cava(IVC), as opposed to coursing posteriorly. When encountered, this artery is mostly accessory and thus accompanied by renal vessels in orthotopic position. Here, we describe an unusual instance of a solitary, main precaval right renal artery. It can be diagnosed preoperatively by a cross-sectional imaging study. Awareness of this anomaly is very important to prevent iatrogenic injury during surgical intervention.
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Affiliation(s)
- Athena Farahzadi
- Fellowship of Surgical Oncology, Cancer Institute Tehran University of Medical Sciences Tehran Iran
| | | | - Nikhil Gopal
- National Institute of Health National Cancer Institute-Urologic Oncology Branch Bethesda Maryland USA
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10
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Ostrowski P, Kotowski MJ, Tejchman K, Szemitko M, Sieńko J, Ostrowski M. The Arterial Anastomosis Between Deep Inferior Epigastric Artery and Small Polar Renal Artery in Kidney Transplantation: A Case Report. Transplant Proc 2022; 54:1145-1147. [PMID: 35568519 DOI: 10.1016/j.transproceed.2022.02.050] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2021] [Accepted: 02/09/2022] [Indexed: 11/16/2022]
Abstract
The presence of multiple renal arteries is the most common form of vascular anomalies found in donor kidneys. In rare cases, small renal polar arteries may be found. They can be anastomosed with deep inferior epigastric arteries, resulting in vascular augmentation of transplanted kidneys and contributing to better graft function. Renal perfusion may be increased via 2 types of vascular reconstruction known as "turbocharging" and "supercharging". Turbocharging uses vascular sources within the same organ area, whereas supercharging uses distant vascular sources. Using additional vessels can either complicate the surgery or, contradictorily, ease the way of procedure. This case study presents a kidney transplant during which arterial anastomosis between deep inferior epigastric artery and small polar renal artery was performed.
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Affiliation(s)
- P Ostrowski
- Department of General Surgery and Transplantation, Pomeranian Medical University, Szczecin, Poland.
| | - M J Kotowski
- Department of General Surgery and Transplantation, Pomeranian Medical University, Szczecin, Poland
| | - K Tejchman
- Department of General Surgery and Transplantation, Pomeranian Medical University, Szczecin, Poland
| | - M Szemitko
- Department of General Surgery and Transplantation, Pomeranian Medical University, Szczecin, Poland
| | - J Sieńko
- Department of General Surgery and Transplantation, Pomeranian Medical University, Szczecin, Poland
| | - M Ostrowski
- Department of General Surgery and Transplantation, Pomeranian Medical University, Szczecin, Poland
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11
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Funes Hernandez M, Bhalla V, Isom RT. Hypothesis: Accessory renal arteries may be an overlooked cause of renin-dependent hypertension. J Hum Hypertens 2022; 36:493-497. [PMID: 34785773 DOI: 10.1038/s41371-021-00632-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2021] [Revised: 09/14/2021] [Accepted: 10/26/2021] [Indexed: 11/09/2022]
Affiliation(s)
- Mario Funes Hernandez
- Stanford Hypertension Center, Stanford University School of Medicine, Stanford, CA, USA.,Division of Nephrology, Department of Medicine, Stanford University School of Medicine, Stanford, CA, USA
| | - Vivek Bhalla
- Stanford Hypertension Center, Stanford University School of Medicine, Stanford, CA, USA.,Division of Nephrology, Department of Medicine, Stanford University School of Medicine, Stanford, CA, USA
| | - Robert T Isom
- Stanford Hypertension Center, Stanford University School of Medicine, Stanford, CA, USA. .,Division of Nephrology, Department of Medicine, Stanford University School of Medicine, Stanford, CA, USA.
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12
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Li S, Phillips JK. Patient Selection for Renal Denervation in Hypertensive Patients: What Makes a Good Candidate? Vasc Health Risk Manag 2022; 18:375-386. [PMID: 35592729 PMCID: PMC9113553 DOI: 10.2147/vhrm.s270182] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2022] [Accepted: 04/22/2022] [Indexed: 01/03/2023] Open
Affiliation(s)
- Sheran Li
- Macquarie Medical School, Faculty of Medicine, Health and Human Sciences, Macquarie University, Sydney, New South Wales, Australia
- Department of Emergency Medicine, Sun Yat-sen Memorial Hospital of Sun Yat-sen University, Guangzhou, People’s Republic of China
- Correspondence: Sheran Li, Department of Emergency Medicine, Sun Yat-sen Memorial Hospital of Sun Yat-sen University, 107 West Yanjiang Road, Yuexiu District, Guangzhou, Guangdong Province, 510120, People’s Republic of China, Tel +86 20 81332723, Fax +86 20 8133 2650, Email
| | - Jacqueline K Phillips
- Macquarie Medical School, Faculty of Medicine, Health and Human Sciences, Macquarie University, Sydney, New South Wales, Australia
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13
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Cisneros Gimeno A, Barrios A, Nogue J, Orozco J. Description of an atypical vascular arch in the renal parenchyma. J ANAT SOC INDIA 2022. [DOI: 10.4103/jasi.jasi_83_21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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14
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Kamanda MI. Left double polar renal arteries, left triplicate (preaortic, accessory and retroaortic) renal veins associated with extrinsic pelviureteric junction obstruction and posterior nutcracker phenomenon. BJR Case Rep 2021; 7:20200086. [PMID: 35136615 PMCID: PMC8803247 DOI: 10.1259/bjrcr.20200086] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2020] [Revised: 04/23/2021] [Accepted: 04/27/2021] [Indexed: 11/05/2022] Open
Abstract
The renal vasculature and its various congenital anomalies have been studied and documented widely in the literature. However, the concomitant occurrence of renovascular morphological anomalies with vascular compression phenomena in a single patient is a rarity. This is a case of a patient with double left renal arteries, preaortic, accessory and retroaortic left renal veins. There was also associated with vascular compression phenomena in the form of posterior nutcracker phenomenon and pelviureteric junction obstruction (PUJ) due to the double-crossing inferior left polar renal artery and retroaortic vein.
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15
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O'Kelly F, Lorenzo AJ, Zubi F, De Cotiis K, Farhat WA, Koyle MA. The impact of multiple donor renal arteries on perioperative complications and allograft survival in paediatric renal transplantation. J Pediatr Urol 2021; 17:541.e1-541.e11. [PMID: 33883096 DOI: 10.1016/j.jpurol.2021.03.016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/10/2020] [Revised: 01/21/2021] [Accepted: 03/18/2021] [Indexed: 11/29/2022]
Abstract
BACKGROUND The impact of using allografts with multiple renal arteries in paediatric kidney transplantation has not been clearly established. The aim of this study was to determine whether kidney grafts with multiple arteries pose any adverse effects upon perioperative surgical outcomes, and graft survival up to 12 months post-transplant. OBJECTIVE The objective of this study was to perform a comparative analysis of a minimum of 12-month graft survival and transplant renal function in paediatric renal transplant recipients receiving single versus multiple donor arteries, and to assess perioperative and early post-operative surgical outcomes. STUDY DESIGN A retrospective divisional chart review of 379 transplants performed (2000-2018), of which 90 (23.7%) contained multiple donor arteries. The number of arteries of the graft, donor type, vascular reconstruction technique, occurrence of urological and vascular complications, estimated GFR and graft survival up to 12 months post-transplantation, graft loss and mortality were analysed. Comparisons in baseline characteristics and outcome measures were made between both groups. RESULTS No significant differences were found in age (p = 0.42), BMI (p = 0.39), estimated intraoperative blood loss (p = 0.14), overall (p = 0.63) or warm ischaemic time (p = 0.37). 51.3% patients with multiple donor arteries underwent an ex vivo reconstruction. There were no differences in the site of arterial anastomosis (aorta, external iliac, internal iliac), or anastomotic type (end-side; end-end). Whilst there was a significantly higher post-operative lymphocoele rate in the multiple vessel cohort (p = 0.024), there was no increase in post-transplant urine leaks, rejection episodes, graft loss (1.1% multiple vs 2.1% single), perioperative complications (p = 0.68), or estimated GFR at 1 month (p = 0.9) or at 1 year (p = 0.67). DISCUSSION We demonstrated in this study that there was no significant difference in postoperative complications up to 3 months, eGFR and renal function up to 1 year, and graft survival up to 4 years post transplantation irrespective of allograft type or reconstruction technique. There was however, a higher rate of lymphocoeles in the multiple artery cohort. The results seen here broadly mirror trends seen in adult studies, however, there is little data available from paediatric series. CONCLUSION Our study demonstrates that multiple renal artery allografts - previously been considered to carry a high complication risk - can be safely used for paediatric renal transplantation with equivalent perioperative complications and graft outcomes to single artery allografts.
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Affiliation(s)
- F O'Kelly
- Division of Pediatric Urology, Hospital for Sick Children, Toronto, Canada; Division of Paediatric Urology, Beacon Hospital, University College, Dublin, Ireland.
| | - A J Lorenzo
- Division of Pediatric Urology, Hospital for Sick Children, Toronto, Canada
| | - F Zubi
- Division of Pediatric Urology, Hospital for Sick Children, Toronto, Canada
| | - K De Cotiis
- Division of Pediatric Urology, Hospital for Sick Children, Toronto, Canada; Division of Pediatric Urology, Neymours/duPont Childrens Hospital, Delaware, USA
| | - W A Farhat
- Division of Pediatric Urology, Hospital for Sick Children, Toronto, Canada; Division of Pediatric Urology, American Family Childrens Hospital, Wisconsin, USA
| | - M A Koyle
- Division of Pediatric Urology, Hospital for Sick Children, Toronto, Canada
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16
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Hayata K, Ojima T, Nakamura M, Kitadani J, Takeuchi A, Yamaue H. Curative para-Aortic lymph node dissection Via INfra-mesocolonic approach in laparoscopic Gastrectomy (CAVING approach). Langenbecks Arch Surg 2021; 406:2067-2074. [PMID: 34018040 DOI: 10.1007/s00423-021-02198-6] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2021] [Accepted: 05/10/2021] [Indexed: 01/21/2023]
Abstract
PURPOSE Para-aortic lymph node (PAN) metastasis for gastric cancer is considered a distant lymph node metastasis. Meanwhile, multidisciplinary treatments have improved survival of patients with PAN metastases. We developed a novel technique of curative para-aortic lymph node dissection via infra-mesocolonic approach in laparoscopic gastrectomy (CAVING approach). This method minimizes the mobilization of the pancreas and the spleen and maximizes the view from the caudal side resembling cave exploration. METHODS After laparoscopic gastrectomy, PAN dissection is performed using the same ports setup. The retroperitoneum is widely exposed to ease anatomical cognition and for troubleshooting. The inferior vena cava, the left gonadal vein, the left renal vein, and the aorta are recognized under Gerota's fascia. The retroperitoneum is then divided into four sections. We perform PAN dissection in the order of 16blat, 16b1int, 16a2lat, and then 16a2int. Using the CAVING approach, the caudal side of the root of the superior mesenteric artery can then be dissected below the pancreas, and only the cranial side of the SMA root requires a suprapancreatic approach. RESULTS In three cases, preoperative chemotherapy and laparoscopic gastrectomy plus D2 with PAN dissection were performed for gastric cancer and esophagogastric junction cancer. The median operation totaled 484 min, 142 min for the PAN dissection. The median whole blood loss was 130 ml. The median harvested number of PAN was 25. CONCLUSIONS The minimal mobilization of pancreas and the wide surgical fields by CAVING approach may facilitate safe and reliable PAN dissection.
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Affiliation(s)
- Keiji Hayata
- Second Department of Surgery, School of Medicine, Wakayama Medical University, 811-1 Kimiidera, Wakayama, 641-8510, Japan
| | - Toshiyasu Ojima
- Second Department of Surgery, School of Medicine, Wakayama Medical University, 811-1 Kimiidera, Wakayama, 641-8510, Japan.
| | - Masaki Nakamura
- Second Department of Surgery, School of Medicine, Wakayama Medical University, 811-1 Kimiidera, Wakayama, 641-8510, Japan
| | - Junya Kitadani
- Second Department of Surgery, School of Medicine, Wakayama Medical University, 811-1 Kimiidera, Wakayama, 641-8510, Japan
| | - Akihiro Takeuchi
- Second Department of Surgery, School of Medicine, Wakayama Medical University, 811-1 Kimiidera, Wakayama, 641-8510, Japan
| | - Hiroki Yamaue
- Second Department of Surgery, School of Medicine, Wakayama Medical University, 811-1 Kimiidera, Wakayama, 641-8510, Japan
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17
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Weber MA, Osborn JW. Improved Understanding of Renal Nerve Anatomy: An Opportunity to Enhance Denervation Treatment of Hypertension. JACC Cardiovasc Interv 2021; 14:316-318. [PMID: 33541542 DOI: 10.1016/j.jcin.2020.11.003] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/15/2020] [Revised: 10/27/2020] [Accepted: 11/03/2020] [Indexed: 12/29/2022]
Affiliation(s)
- Michael A Weber
- Division of Cardiovascular Medicine, State University of New York, Downstate College of Medical, Brooklyn, New York, USA.
| | - John W Osborn
- Department of Surgery, University of Minnesota, Minneapolis, Minnesota, USA
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18
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Smit JHA, Leonardi EP, Chaves RHDF, Furlaneto IP, da Silva CMS, Abib SDCV, Góes AMDO. Image-guided study of swine anatomy as a tool for urologic surgery research and training. Acta Cir Bras 2021; 35:e351208. [PMID: 33503221 PMCID: PMC7819699 DOI: 10.1590/acb351208] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2020] [Revised: 10/10/2020] [Accepted: 11/11/2020] [Indexed: 01/01/2023] Open
Abstract
PURPOSE To describe the anatomy of the swine urinary system using computed tomography and to discuss the role of this animal as an experimental model for urological procedures. METHODS Three male Landrace pigs underwent computed tomography and the anatomy of the urinary system and renal circulation was analyzed and described. RESULTS In all animals, 2 kidneys, 2 ureters and one bladder were identified. Each kidney presented a single renal artery vascularization, with a mean diameter on the right of 4.45 and 5.31 mm on the left (p < 0.0001) and single renal vein drainage, with a mean diameter on the right of 5.78 and 5.82 mm on the left (p = 0.0336). The average renal length was 9.85 cm on the right and 10.30 cm on the left (p < 0.0001). The average renal volume was 113.70 cm3 on the right and 109.70 cm3 on the left (p < 0.0001). The average length of the ureter was 19.78 cm on the right and 22.08 cm on the left (p < 0.0001). The average bladder volume was 423.70 cm3. CONCLUSIONS The data obtained show similarities with human anatomy, suggesting the viability of the swine model for planning preclinical trials, basic research, refinement in experimental surgery and surgical training for urological procedures.
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Affiliation(s)
| | - Eduardo Piotto Leonardi
- MSc, Associate Professor, Department of Urology, School of
Medicine, Centro Universitário do Estado do Pará, Belém-PA, Brazil
| | | | - Ismari Perini Furlaneto
- PhD, Grupo de Pesquisa Experimental, Centro Universitário do Estado
do Pará, Belém-PA, Brazil
| | - Cezar Massoud Salame da Silva
- MSc, Associate Professor, Department of Radiology, School of
Medicine, Centro Universitário do Estado do Pará, Belém-PA, Brazil
| | | | - Adenauer Marinho de Oliveira Góes
- PhD, Full Professor, Department of Vascular Surgery, Grupo de
Pesquisa Experimental, Centro Universitário do Estado do Pará, Belém-PA,
Brazil
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19
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A Unique Case of Incomplete Bifid Ureter and Associated Arterial Variations. Case Rep Urol 2021; 2021:6655813. [PMID: 33489410 PMCID: PMC7801057 DOI: 10.1155/2021/6655813] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2020] [Revised: 12/08/2020] [Accepted: 12/23/2020] [Indexed: 11/20/2022] Open
Abstract
Introduction. Urogenital and vascular anomalies, including a left duplex kidney and a left aberrant renal artery that gave rise to the left ovarian artery, were observed in a 77-year-old female cadaver during a routine dissection. Description. A left aberrant renal artery, which gave rise to the left ovarian artery, was observed originating from the aorta 4 cm below the left renal artery. Two independent contributions to a bifid ureter were found originating from the hilum of the left kidney. These two contributions descended 12.4 cm and 10.6 cm, respectively, posterior to the left aberrant renal artery and lateral to the left ovarian artery before uniting anterior to the psoas major muscle to descend 12.7 cm to the bladder. Significance. While the duplex kidney is a relatively common congenital anomaly that can be asymptomatic, it can also potentially be associated with compression of renal vasculature or the ureter. Ureteral compression can then result in several pathologies including reflux, urinary tract infection (UTI), ureteropelvic junction obstruction, or hydronephrosis. Compression of renal and ovarian vasculature can result in altered blood flow to the kidney and ovary, potentially causing fibrosis, atrophy, or organ failure. Current imaging techniques alone are insufficient for correct diagnostics of such complications, and they must be supplemented with a thorough understanding of the respective anatomical variations.
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Yufa A, Mikael A, Lara G, Nurick H, Andacheh I. Accessory renal arteries involved in atherosclerotic occlusive disease at the aortic bifurcation. JOURNAL OF VASCULAR SURGERY CASES INNOVATIONS AND TECHNIQUES 2020; 6:425-429. [PMID: 33367190 PMCID: PMC7748983 DOI: 10.1016/j.jvscit.2020.06.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/13/2020] [Accepted: 06/02/2020] [Indexed: 11/28/2022]
Abstract
Accessory renal arteries (ARAs) are embryonic remnants found in more than one-third of patients and occurring bilaterally in 10% of the population. Very few reports have documented such vessels arising near or at the level of the aortic bifurcation. Furthermore, the presence of ARAs has yet to be described in the context of atherosclerotic disease. Here, we present a unique case of large bilateral ARAs originating above the aortic bifurcation concurrent with symptomatic aortoiliac atherosclerotic disease. We highlight the embryologic and clinical significance of these vessels as well as discuss their potential role in accelerating atherosclerotic disease processes.
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Affiliation(s)
- Ann Yufa
- University of California, Riverside School of Medicine, Riverside, Calif.,Riverside Community Hospital, Riverside, Calif
| | | | - Gustavo Lara
- Riverside Community Hospital, Riverside, Calif.,Harvey Nurick, MD, Inc, Riverside, Calif
| | - Harvey Nurick
- Riverside Community Hospital, Riverside, Calif.,Harvey Nurick, MD, Inc, Riverside, Calif
| | - Iden Andacheh
- University of California, Riverside School of Medicine, Riverside, Calif.,Riverside Community Hospital, Riverside, Calif.,Harvey Nurick, MD, Inc, Riverside, Calif
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21
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Mahajan AD, Patel ND, Singh Pal L, Bathe S, Darakh PP, Patil M. Retrospective Analysis of the Comparison Between Single Renal Artery Versus Multiple Renal Arteries in Living Donor Kidney Transplant: Does It Affect the Outcome? EXP CLIN TRANSPLANT 2020; 19:38-43. [PMID: 33272157 DOI: 10.6002/ect.2020.0244] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
OBJECTIVES There is an increased risk of vascular complications in kidney transplant for allografts with multiple renal arteries versus a single renal artery. We compared the clinical outcomes of living donor kidney transplant recipients who received allografts with a single renal artery versus multiple renal arteries. MATERIALS AND METHODS This retrospective analysis included all living-related donor kidney transplants that were performed by a single skilled urologist. All donor nephrectomies were performed by open method. The left kidney was preferred over the right for donor nephrectomy, except in cases of vascular problems or other contraindications, for which the right kidney was preferred. In most of the cases, kidneys were placed in the right iliac fossa for transplant by an extraperitoneal approach. RESULTS Of 97 living donor kidney transplants, 82 had a single renal artery (group 1) and 15 had multiple renal arteries (group 2). Patients ranged in age from 18 to 76 years old. Recipient ages (33.00 vs 29.46 years) and baseline serum creatinine values (8.61 vs 8.82 mg/dL) were comparable in groups 1 and 2 (P > .05). However, mean operative time and total ischemia time were significantly higher in the multiple renal artery group (221 and 53.45 minutes, respectively) compared with the single renal artery group (202 and 77.6 minutes, respectively). Graft survival at 1 year was 95.12% in the single renal artery group and 93.33% in the multiple renal artery group. Patient survival at 1 year was 96.34% in the single renal artery group and 93.33% in the multiple renal artery group. CONCLUSIONS The safety of kidney transplants of allografts with multiple renal arteries is equal to the safety of transplants of allografts with a single renal artery in terms of vascular complications and acute tubular necrosis, as well as patient and graft survival.
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Affiliation(s)
- Abhay Dinkar Mahajan
- From the Mahatma Gandhi Mission's Medical College and Hospital, Aurangabad, India
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22
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Sato Y, Kawakami R, Jinnouchi H, Sakamoto A, Cornelissen A, Mori M, Kawai K, Guo L, Coleman L, Nash S, Claude L, Barman NC, Romero M, Kolodgie FD, Virmani R, Finn AV. Comprehensive Assessment of Human Accessory Renal Artery Periarterial Renal Sympathetic Nerve Distribution. JACC Cardiovasc Interv 2020; 14:304-315. [PMID: 33541541 DOI: 10.1016/j.jcin.2020.09.043] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/09/2020] [Revised: 09/24/2020] [Accepted: 09/29/2020] [Indexed: 10/22/2022]
Abstract
OBJECTIVES The aim of this study was to understand the anatomy of periarterial nerve distribution in human accessory renal arteries (ARAs). BACKGROUND Renal denervation is a promising technique for blood pressure control. Despite the high prevalence of ARAs, the anatomic distribution of periarterial nerves around ARAs remains unknown. METHODS Kidneys with surrounding tissues were collected from human autopsy subjects, and histological evaluation was performed using morphometric software. An ARA was defined as an artery arising from the aorta above or below the dominant renal artery (DRA) or an artery that bifurcated within 20 mm of the takeoff of the DRA from the aorta. The DRA was defined as an artery that perfused >50% of the kidney. RESULTS A total of 7,287 nerves from 14 ARAs and 9 DRAs were evaluated. The number of nerves was smaller in the ARA than DRA (median: 30 [interquartile range: 17.5 to 48.5] vs. 49 [interquartile range: 36 to 76]; p < 0.0001). In both ARAs and DRAs, the distance from the arterial lumen to nerve was shortest in the distal, followed by the middle and proximal segments. On the basis of the post-mortem angiography, ARAs were divided into large (≥3 mm diameter) and small (<3 mm) groups. The number of nerves was greatest in the DRA, followed by the large and small ARA groups (53 [41 to 97], 38 [25 to 53], and 24.5 [10.5 to 36.3], respectively; p = 0.001). CONCLUSIONS ARAs showed a smaller number of nerves than DRAs, but these results were dependent on the size of the ARA. Ablation, especially in large ARAs, may allow more complete denervation with the potential to further reduce blood pressure.
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Affiliation(s)
- Yu Sato
- CVPath Institute, Gaithersburg, Maryland, USA
| | | | | | | | | | | | - Kenji Kawai
- CVPath Institute, Gaithersburg, Maryland, USA
| | - Liang Guo
- CVPath Institute, Gaithersburg, Maryland, USA
| | | | | | | | | | | | | | | | - Aloke V Finn
- CVPath Institute, Gaithersburg, Maryland, USA; University of Maryland, Baltimore, Maryland, USA.
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Waśniewska A, Bukowski P, Szymański R, Januszewicz A, Olewnik Ł. Coexistence of a rare type of ectopic kidney with atypical renal vasculature. Anat Sci Int 2020; 96:326-331. [PMID: 33141422 PMCID: PMC7870757 DOI: 10.1007/s12565-020-00584-6] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2020] [Accepted: 10/16/2020] [Indexed: 11/30/2022]
Abstract
Knowledge of anatomical anomalies is significant for all specialists in clinical practice and may prevent serious complications following medical procedures. This report presents the rare crossed fused renal ectopia (CFRE) with atypical renal vasculature in cadaver of a 68-year-old man. The ectopic kidney was located on right side with four renal veins, three renal arteries, two ureters, where one of them is double. The embryological background, as well as the potential clinical significance of this morphological variation, is discussed. An interventional radiological and surgical procedure should be appropriately implemented to treat anomalies of vessels and CFRE.
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Affiliation(s)
- Anna Waśniewska
- Department of Normal and Clinical Anatomy, Interfaculty Chair of Anatomy and Histology, Medical University of Lodz, Żeligowskiego 7/9, 90-752, Łódź, Poland.
| | - Piotr Bukowski
- Department of Normal and Clinical Anatomy, Interfaculty Chair of Anatomy and Histology, Medical University of Lodz, Żeligowskiego 7/9, 90-752, Łódź, Poland
| | - Rafał Szymański
- Department of Histology, Chair of Anatomy and Histology, Medical University of Lodz, Łódź, Poland
| | | | - Łukasz Olewnik
- Department of Anatomical Dissection and Donation, Chair of Anatomy and Histology, Medical University of Lodz, Łódź, Poland
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25
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Lee HB, Yang J, Maeng YH, Yoon SP. Bilateral multiple renal arteries with an extra-aortic origin and quadruple testicular veins. Anat Cell Biol 2019; 52:518-521. [PMID: 31949992 PMCID: PMC6952688 DOI: 10.5115/acb.19.159] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2019] [Revised: 09/26/2019] [Accepted: 09/27/2019] [Indexed: 11/27/2022] Open
Abstract
Although variations in the urogenital vessels are relatively common, a rare case of asymmetric bilateral multiple renal arteries originating not only from the aorta but also from the testicular artery was found in a 75-year-old Korean male cadaver. Three renal arteries arose from the lateral aspect of the abdominal aorta on the right side and four from the left side. Two additional renal parenchymal branches originated from the left testicular artery, accompanied by a pair of veins out of the four testicular veins on the left side. Embryological development of the urogenital vessels is of particular importance for anatomists and clinicians.
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Affiliation(s)
- Hyun-Bong Lee
- Medical Course, Jeju National University School of Medicine, Jeju, Korea
| | - Joseph Yang
- Medical Course, Jeju National University School of Medicine, Jeju, Korea
| | - Young Hee Maeng
- Department of Pathology, Jeju National University School of Medicine, Jeju, Korea
| | - Sang-Pil Yoon
- Department of Anatomy, Jeju National University School of Medicine, Jeju, Korea.,Institute for Medical Science, Jeju National University, Jeju, Korea
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The level of origin of renal arteries in horseshoe kidney vs. in separated kidneys: CT-based study. Surg Radiol Anat 2018; 40:1185-1191. [PMID: 30043151 PMCID: PMC6153647 DOI: 10.1007/s00276-018-2071-8] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2018] [Accepted: 07/16/2018] [Indexed: 12/19/2022]
Abstract
Purpose Horseshoe kidney is a rare congenital anomaly with potential clinical implications. The aim of this study was to determine the number of renal arteries and veins and the level at which the arteries branched off their parental vessels in individuals with horseshoe kidney (HSK) and in persons with separated kidneys (SK). Materials and methods The analysis included computed tomography angiography studies of 331 patients (83 HSK and 248 SK). The number of renal vessels and diameters of renal arteries were determined, along with the level at which they branched in relation to other ramifications (four groups of origin were proposed) and their entrance of the vessels to the kidney. Results Number of renal arteries in HSK group was 4.57 ± 1.39 per patient and 2.4 ± 0.43 in SK group (p < 0.0001). The distribution of branching level of renal arteries in HSK group was: I group ~ 57%, II group ~ 27%, III group ~ 15% and IV group < 1%, whereas in SK group the distribution was respectively: I group ~ 99%, II group < 1%, III and IV group − 0% (p = 0.0001). In HSK group, diameter of renal arteries branching above the IMA was 4.61 ± 1.58 mm, as compared with 3.96 ± 1.34 mm for the arteries branching below (p = 0.0004). Number of veins was 566 in SK group (87.70% of kidneys were supplied by single vein) and 323 in HSK group (9.64% kidneys were supplied by two veins) (p < 0.0001). Conclusion In HSK group, renal arteries significantly more often branch off their parental vessels below the origin of IMA and such vessels are usually smaller.
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