Die Übergangszone in der Tunica media der Nierenarterie mit einer maximalen Länge von 10 Millimetern

VASA ◽  
2000 ◽  
Vol 29 (3) ◽  
pp. 168-172 ◽  
Author(s):  
Jan Janzen ◽  
Lanzer ◽  
Rothenberger-Janzen ◽  
Vuong
Keyword(s):  
Renal Artery ◽  
Transitional Zone ◽  
Biomechanical Properties ◽  
Renal Arteries ◽  
Elastic Tissue ◽  
Tunica Media ◽  
Biomechanical Behavior ◽  
Arterial Structure ◽  
The Right ◽  
The Impact

Background: The goal of our study was to demonstrate and to determine the length of the transitional zone in the tunica media in renal arteries. The majority of renal artery atherosclerotic stenotic lesions occurs in this segment. Patients and methods: Anatomical and histological studies were performed on 26 renal arteries from 13 adults at autopsy (mean age 61.6 years, range 33 to 87 years). Results: In the macroscopical examination the right renal arteries (RRA) were longer with a median 53.8 mm (range 38 to 65 mm) than the left renal arteries (LRA) with a median 47.6 mm (range 35 to 63 mm), the circumferences were nearly the same: RRA 10.9 mm (range 5 mm to 15 mm) and LRA 11 mm (range 5 mm to 15 mm). Probes for histological examinations were taken from three different regions of each renal artery (origin, 5 mm and 10 mm distal to the origin). We observed a typical elastic arterial structure at the origin and muscular types at the distal 10 mm region. At the distal 5 mm region variable ratios of elastic tissue (ET) and smooth muscle cells (SMC) were found as follows: 15 arteries presented an equal ratio of EM : SMC, 7 arteries presented ET > SMC and 4 arteries presented ET < SMC ratios. Conclusions: In this study we confirmed that in renal arteries, a transitional zone (TZ) that is an arterial segment with transition from elastic to muscular type, does exist, involving the maximal length of 10 mm. Further studies on the impact of the biomechanical properties of the transitional zone as a potential localizing factor in renal atherosclerotic disease are justified. In addition, the complex biomechanical behavior of the TZ of the arterial wall should be taken into consideration when interventional procedures are planned.

Die unterschiedliche Ausdehnung der Übergangszone in der Karotisgabel

VASA ◽  
2001 ◽  
Vol 30 (2) ◽  
pp. 101-106 ◽  
Author(s):  
J. Janzen ◽  
P. Lanzer ◽  
K. Rothenberger-Janzen ◽  
P.N. Vuong
Keyword(s):  
Carotid Artery ◽  
Transitional Zone ◽  
Biomechanical Properties ◽  
Elastic Fibers ◽  
Arterial Segment ◽  
Biomechanical Behavior ◽  
Atherosclerotic Lesions ◽  
The Media ◽  
Potential Factor ◽  
The Impact

Background: The goal of our study was to demonstrate the extension of the transitional zone (TZ) between elastic and muscular medial structure in carotid artery tripod. Patients and methods: A histologic study of 56 probes from 8 carotid artery tripods was performed. The probes were obtained from autopsies of 4 adults (mean age: 47.5 years, range 38 to 55 years) and were taken from 7 different topographic sites. Results: At each level of the CCA (at 1 cm and 2 cm proximal to the bifurcation as well as at the bifurcation) we observed an elastic arterial type in 24 (42.8%) probes with 11 to 20 (medium 15.0) elastic fibers per view field (200 ¥ magnification) in the media. In contrast the histologic structure of the ICA and ECA varied as follows: in 8 sections (14.3%) elastic arterial type with 11 to 16 (medium 13.1) elastic fibers, in 11 sections (19.6%) muscular arterial type with 2 to 5 (medium 3.5) elastic fibers and in 9 sections (16.1%) a transitional arterial type with 6 to 8 (medium 6.7) elastic fibers in the media. Atherosclerotic lesions have prevented the assessment of the arterial type in 4 probes (7.1%). The TZ in the medial structure of carotid artery tripods is exclusively localized in the ICA/ECA but not in the CCA. The ICA/ECA presented a TZ with a length up to 0.5 cm (4 probes; 25%), up to 1.5 cm (4 probes; 25%) and longer than 1.5 cm (6 probes; 37.5%). Conclusions: In this study we confirmed that in the carotid artery tripod, a TZ – an arterial segment with transition from elastic to muscular type – does exist, involving a variable length. Furthermore studies on the impact of the biomechanical properties of the TZ as a potential factor in atherosclerotic disease are justified. In addition, the complex biomechanical behavior of the TZ should be considered prior to interventional procedures.

Ex Vivo Repair of a Renal Artery Saccular Aneurysm in a Living-Nonrelated Donor and Subsequent Successful Kidney Transplantation

2018 ◽  
Vol 52 (6) ◽  
pp. 455-458
Author(s):  
Rogerio A. Muñoz-Vigna ◽  
Javier E. Anaya-Ayala ◽  
Juan N. Ramirez-Robles ◽  
Daniel Nuño-Diaz ◽  
Sandra Olivares-Cruz
Keyword(s):  
Kidney Transplantation ◽  
Renal Artery ◽  
Ex Vivo ◽  
Incidental Finding ◽  
Left Kidney ◽  
Renal Arteries ◽  
Saccular Aneurysm ◽  
Preoperative Imaging ◽  
The Right ◽  
Stage Renal Disease

The use of kidney grafts with aneurysmal disease involving the renal arteries for transplantation is very uncommon and relatively controversial. We herein present the case of a 52-year-old woman who volunteered to become a living-nonrelated donor; during the preoperative imaging workup, a computed tomography angiography revealed a 1.5-cm saccular aneurysm in the left kidney, while the contralateral renal artery was normal. We decided to utilize the left kidney for a 25-year-old male patient with end-stage renal disease, and following the ex vivo repair using the recipient epigastric vessels and saphenous veins, we completed the transplantation in the right pelvic fossa. The postoperative period was uneventful, and at 8 months from the surgery, the graft remains functional. The surgical repair of renal artery aneurysms followed by immediate kidney transplantation is a safe technique and an effective replacement therapy for recipients. The incidental finding of isolated aneurysmal disease in renal arteries should not exclude graft potential availability for transplantation following repair.

scholarly journals Origin, Traject and Distribution of Renal Arteries (Arteriae renalis) in Chinchilla lanigera

2018 ◽  
Vol 75 (1) ◽  
pp. 129
Author(s):  
Cristian MARTONOS ◽  
Cristian DEZDROBITU ◽  
Florin STAN ◽  
Aurel DAMIAN ◽  
Alexandru GUDEA
Keyword(s):  
Renal Artery ◽  
Renal Arteries ◽  
Left Renal Artery ◽  
Lateral Part ◽  
Formaldehyde Solution ◽  
Anatomical Dissection ◽  
The Right ◽  
High Degree ◽  
Aorta Abdominalis ◽  
Degree Of Similarity

For the present study a number of 5 female chinchilla carcasses were used. The animals were slaughtered for commercial purpuses (fur). The anatomical dissection started with the identification of the aorta (Aorta abdominalis). The next step was the intra-arterial injection of a colouring substance. The carcasses was fixed in the formaldehyde solution and subsequently the renal arteries were dissected. The first renal artery was the right renal artery (Arteria renalis dextra) and, at 0,5 cm caudally, the left renal artery (Arteria renalis sinister) arose . The origin of those arteries were disposed on the lateral part of the abdominal aorta.The origin, traject and distribution of renal arteries on the studied species have a high degree of similarity with the literature dates described for leporids.

Cardiac Pulsatility– and Respiratory-Induced Deformations of the Renal Arteries and Snorkel Stents After Snorkel Endovascular Aneurysm Sealing

2019 ◽  
Vol 26 (4) ◽  
pp. 556-564
Author(s):  
Christopher P. Cheng ◽  
Ga-Young Suh ◽  
John J. Kim ◽  
Andrew Holden
Keyword(s):  
Renal Artery ◽  
Endovascular Aneurysm Repair ◽  
Renal Arteries ◽  
Aortic Aneurysms ◽  
Left Renal Artery ◽  
3 Dimensional ◽  
Maximum Curvature ◽  
Mechanical Durability ◽  
The Right ◽  
Aneurysm Repair

Purpose: To quantify deformations of renal arteries and snorkel stents after snorkel endovascular aneurysm sealing (Sn-EVAS) resulting from cardiac pulsatility and respiration and compare these deformations to patients with untreated abdominal aortic aneurysms (AAA) and snorkel endovascular aneurysm repair (Sn-EVAR). Materials and Methods: Ten Sn-EVAS patients (mean age 75±6 years; 8 men) were scanned with cardiac-gated, respiration-resolved computed tomography angiography. From 3-dimensional geometric models, changes in renal artery and stent angulation and curvature due to cardiac pulsatility and respiration were quantified. Respiration-induced motions were compared with those of 16 previously reported untreated AAA patients and 11 Sn-EVAR patients. Results: Renal artery bending at the stent end was greater for respiratory vs cardiac influences (6°±7° vs −1°±2°, p<0.025). Respiration caused a 3-fold greater deformation on the left renal artery as compared with the right side. Maximum curvature change was higher for respiratory vs cardiac influences (0.49±0.29 vs 0.24±0.17 cm−1, p<0.025), and snorkel renal stents experienced similar maximum curvature change due to cardiac pulsatility and respiration (0.14±0.10 vs 0.19±0.09 cm−1, p=0.142). When comparing the 3 patient cohorts for respiratory-induced deformation, there was significant renal branch angulation in untreated AAAs, but not in Sn-EVAR or Sn-EVAS, and there was significant bending at the stent end in Sn-EVAR and Sn-EVAS. Maximum curvature change due to respiration was ~10-fold greater in Sn-EVAR and Sn-EVAS compared to untreated AAAs. Conclusion: The findings suggest that cardiac and respiratory influences may challenge the mechanical durability of snorkel stents of Sn-EVAS; similarly, however, respiration may be the primary culprit for tissue irritation, increasing the risk for stent-end thrombosis, especially in the left renal artery. The bending stiffness of snorkel stents in both the Sn-EVAR and Sn-EVAS cohorts damped renal branch angulation while it intensified bending of the artery distal to the snorkel stent. Understanding these device-to-artery interactions is critical as they may affect mechanical durability of branch stents and quality and durability of treatment.

scholarly journals Extended Renal Artery Denervation Is Associated with Artery Wall Lesions and Acute Systemic and Pulmonary Hemodynamic Changes: A Sham-Controlled Experimental Study

2020 ◽  
Vol 2020 ◽  
pp. 1-8
Author(s):  
Aleksandr D. Vakhrushev ◽  
Heber Ivan Condori Leandro ◽  
Natalia S. Goncharova ◽  
Lev E. Korobchenko ◽  
Lubov B. Mitrofanova ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Renal Artery ◽  
Systolic Blood Pressure ◽  
Renal Arteries ◽  
Artery Wall ◽  
Pulmonary Hemodynamics ◽  
Pulmonary Hemodynamic ◽  
Renal Artery Denervation ◽  
The Impact ◽  
Wall Lesions

Objectives. We sought to assess acute changes in systemic and pulmonary hemodynamics and microscopic artery lesions following extended renal artery denervation (RDN). Background. RDN has been proposed to reduce sympathetic nervous system hyperactivation. Although the effects of RDN on systemic circulation and overall sympathetic activity have been studied, data on the impact of RDN on pulmonary hemodynamics is lacking. Methods. The study comprised 13 normotensive Landrace pigs. After randomization, 7 animals were allocated to the group of bilateral RDN and 6 animals to the group of a sham procedure (SHAM). Hemodynamic measures, cannulation, and balloon-based occlusion of the renal arteries were performed in both groups. In the RDN group, radiofrequency ablation was performed in all available arteries and their segments. An autopsy study of the renal arteries was carried out in both groups. Results. The analysis was performed on 12 pigs (6 in either group) since pulmonary thromboembolism occurred in one case. A statistically significant drop in the mean diastolic pulmonary artery pressure (PAP) was detected in the RDN group when compared with the SHAM group (change by 13.0 ± 4.4 and 10.0 ± 3.0   mmHg , correspondingly; P = 0.04 ). In 5 out of 6 pigs in the RDN group, a significant decrease in systemic systolic blood pressure was found, when compared with baseline ( 98.8 ± 17.8 vs. 90.2 ± 12.6   mmHg , P = 0.04 ), and a lower mean pulmonary vascular resistance (PVR) ( 291.0 ± 77.4 vs. 228.5 ± 63.8   dyn ∗ sec ∗ c m − 5 , P = 0.03 ) after ablation was found. Artery dissections were found in both groups, with prevalence in animals after RDN. Conclusions. Extensive RDN leads to a rapid and significant decrease in PAP. In the majority of cases, RDN is associated with an acute lowering of systolic blood pressure and PVR. Extended RDN is associated with artery wall lesions and thrombus formation underdiagnosed by angiography.

scholarly journals Arterial Pattern of The Kidney In A Bangladeshi Population - A Postmortem Study

2016 ◽  
Vol 24 (1) ◽  
pp. 12-16
Author(s):  
Fatema Johora ◽  
Abu Sadat Mohammad Nurunnabi ◽  
Dilruba Siddiqua ◽  
Hosna Ara Perven ◽  
Shamim Ara
Keyword(s):  
Renal Artery ◽  
Age Groups ◽  
Renal Arteries ◽  
Branching Pattern ◽  
Renal Angiography ◽  
Medical College ◽  
Group A ◽  
Bangladeshi Population ◽  
The Right ◽  
Accessory Renal Arteries

Context: The kidney is a highly vascular organ in the human body. The aim of the present study was to see the variations in perihilar branching pattern and morphology of the main renal arteries in a Bangladeshi population based on autopsy.Methods: This cross-sectional, descriptive study was done in the Department of Anatomy, Dhaka Medical College, Dhaka, from July 2008 to June 2009, based on collection of 140 post mortem human kidneys from 70 unclaimed dead bodies which were in the morgue. All the samples were divided into three age-groups: A (10-19 years), B (20-39 years) and C (40-59 years). Morphological examination was done to identify main renal arteries and accessory renal arteries with their sites of origin and perihilar branching pattern of the renal arteries as well. The length of the renal artery was measured by using a measuring tape. Besides, renal angiography was done to see the intrarenal branching pattern.Results: The length of the right and left renal arteries were found 3.09±0.08 cm and 2.09±0.09 cm; 3.48±0.17 cm and 2.34±0.17 cm; 3.88±0.17 cm and 2.81±0.16 cm in group A, B and C respectively. The length of the right renal artery was found greater than of the left (P<0.001) in all age-groups. Besides, age related changes were also found in the length of the renal arteries (P<0.001). Accessory renal arteries were present in the right side in 33.4%, 23.35 and 33.3% specimens in group A, B and C respectively, while in the left side, in 59.7%, 27.9% and 13.4% in group A, B and C respectively. The number of anterior divisions of the both renal arteries were 2 in 8.3%, 3 in 12.5% and 4 in 79.2% specimens in group A, while in group B, 2 in 7%, 3 in 17.4% and 4 in 75.6% specimens, and in group C, 2 in 3.3%, 3 in 3.3% and 4 in 93.3% specimens. Number of posterior division was found only 1 in all the groups. Renal angiography revealed intrarenal branching pattern which showed segmental arteries divided into several lobar arteries and interlobar arteries.J Dhaka Medical College, Vol. 24, No.1, April, 2015, Page 12-16

scholarly journals Accessory polar renal artery not pre-operatively visualized at extra-peritoneal para-aortic lymphadenectomy

2019 ◽  
Vol 29 (7) ◽  
pp. 1226-1227 ◽  
Author(s):  
Melisa Madsen ◽  
Mikel Gorostidi ◽  
Ruben Ruiz ◽  
Ibon Jaunarena ◽  
Paloma Cobas ◽  
...  
Keyword(s):  
Renal Artery ◽  
Endometrial Adenocarcinoma ◽  
Vena Cava ◽  
Vascular Complications ◽  
Renal Arteries ◽  
Vascular Anomalies ◽  
Final Report ◽  
Imaging Studies ◽  
Pelvic Mri ◽  
The Right

The objective of this video is to describe the technique of extra-peritoneal para-aortic laparoscopic lymphadenectomy and emphasize potential vascular risks that should be taken into account during the procedure.The procedure was performed at Donostia University Hospital, a tertiary referral and educational center in San Sebastián, Spain.A 58-year-old woman, body mass index 25.4 kg/m2, G2P2, with a diagnosis of intermediate-risk endometrial adenocarcinoma, International Federation of Gynecology and Obstetrics (FIGO) IBG2 based on pre-operative endometrial histology and pre-operative magnetic resonance imaging (MRI), but upstaged to high-risk endometrial adenocarcinoma on final report (IBG3). In our hospital, risk stratification is based on pelvic MRI (myometrial invasion, cervical invasion) and biopsy (histology and grade) to tailor surgery. Computed tomography (CT) scan pre-operatively is only performed for type 2 endometrial carcinoma and grade 3 histologies.The local institutional review board was consulted, which confirmed that the study was exempt from requiring approval.The patient underwent an extra-peritoneal para-aortic laparoscopic lymphadenectomy, trans-peritoneal bilateral pelvic lymphadenectomy, and a total hysterectomy and bilateral salpingo-oophorectomy.It is mandatory to check pre-operative imaging studies in order to identify vascular anomalies that are not uncommon and may increase the risk of vascular complications.1 Frequently these vascular anomalies, such as a retro-aortic left renal vein, or a double vena cava or left vena cava, may be a casual finding in the pre-operative study, and often such findings are not reported by the radiologist. It is vitally important that the surgeon checks for and identifies any such anomolies, as the risk of complications may be decreased if anomalies of this type are detected pre-operatively.In addition, in the case of existing polar renal arteries, these are frequently not identified in the pre-operative study,2 leading to a risk of injury and partial renal necrosis. There are several anatomical variations of the renal arteries, with an aortic lower polar artery found in 3% of cadavers and 1% of patients on CT, more frequently on the right side.3 Renovascular hypertension4 secondary to an injury of an accessory polar renal artery (APRA) has also been described.Although vascular anomalies, especially venous ones, are more frequently found at the infra-renal left level, in this video we show access to the right side of the dissection and the care that needs to be taken in order not to damage a vascular structure at this level. Special caution is required with the right side of the dissection so as not to injure any perforating veins, including Fellow's vein, when pushing all the nodes to the roof of the dissection.The dissection maneuvers are fine and blunt, establishing bridges of tissue to be sectioned, and thus identifying vascular structures, such as a right APRA that is to be identified and preserved.The surgeon must have a good knowledge of retro-peritoneal vascular anatomy, they should examine pre-operative imaging studies to check for vascular anomalies, and they need to possess an accurate surgical technique to avoid potential vascular injury during laparoscopic para-aortic lymphadenectomy.

scholarly journals Rare Clinical Cases of Renal Artery Thrombosis

2021 ◽  
Vol 20 (3) ◽  
pp. 550-555
Author(s):  
Vladimir Vorobev ◽  
Vladimir Beloborodov ◽  
Natalya Balabina ◽  
Konstantin Tolkachev ◽  
Sergei Popov ◽  
...  
Keyword(s):  
Renal Artery ◽  
Medical Science ◽  
Renal Arteries ◽  
Renal Infarction ◽  
Correct Treatment ◽  
Renal Artery Thrombosis ◽  
Artery Thrombosis ◽  
Complete Thrombosis ◽  
The Right ◽  
Clinical Cases

Objective: Renal vascular thrombosis is a thrombotic blockage of the major renal arteries resulting in acute damage or chronic kidney disease. The study aims to analyze rare clinical cases of renal artery thrombosis with following renal infarction. Materials and methods: The article present a retrospective study of examination and treatment results of patients diagnosed with the renal arteries thrombosis in the urological hospital of the Irkutsk Clinical Hospital No. 1 in the period 2012-2020. Results and Discussion: During the entire observation period, there were two clinical cases of acute renal artery thrombosis. The 86-year-old woman developed thrombosis because of atrial fibrillation, which was probably the result of inadequate correction (insufficient dose of anticoagulant). Kidney infarction had complications like rapid suppuration because of chronic urinary infection and calculus of the renal pelvis. It resulted in nephrectomy with subsequent recovery. The second case was the 45-year-old man examined according to existing standards, and the diagnosed-on time in the first hours of the disease. However, complete thrombosis of the right renal artery neutralized the effectiveness of conservative therapy with warfarin. In this case, nephrosclerosis and renal failure were natural. Conclusion: Renal artery thrombosis is a rare pathology that requires special attention from the clinician due to the high risk of renal function loss. Timely diagnosis and correct treatment tactics are especially important. Bangladesh Journal of Medical Science Vol.20(3) 2021 p.550-555

scholarly journals Bilateral Supernumerary Renal Arteries with variant Ureteric Relation and their Embryological and Clinical Significance

2017 ◽  
Vol 06 (01) ◽  
pp. 082-089
Author(s):  
Vidya Gunasekaran ◽  
Gladwin Victor Raj ◽  
Aravindhan Kishore ◽  
Parkash Chand
Keyword(s):  
Renal Artery ◽  
Renal Arteries ◽  
Successful Outcome ◽  
Undergraduate Medical Students ◽  
Renal Vasculature ◽  
Surgical Interventions ◽  
Field Of Vision ◽  
Male Cadaver ◽  
Renal Artery Denervation ◽  
The Right

AbstractVariations in the renal vasculature always deserve a special attention owing to its higher prevalence and wider range. A thorough knowledge of the normal morphology and the variations in the origin, course, branches and distribution of the renal vasculature are essential for the successful outcome of the surgical interventions in this region without dreadful complications. During routine dissection for the undergraduate medical students following the standard procedures, dissection of the retroperitoneal region in a male cadaver, revealed bilateral variations in the number, origin, course and branches of the renal arteries.The renal arteries with its branches were dissected out meticulously and the variations encountered were documented. Bilateral supernumerary renal arteries with extra-hilar and pre-hilar branches were observed. In addition, it was found that the supernumerary inferior pre- caval right renal artery had a variant course in relation to ureter before entering the hilum of the right kidney. The variant renal arteries documented in the present study with their embryological correlation is clinically important in the urological management, especially during the laparoscopic donor nephrectomy, where the field of vision is limited and also in the endovascular renal artery denervation procedure, which is an useful adjuvant for the patients having drug-resistant primary hypertension.

scholarly journals Intrarenal arterial patterns in the wolf (Canis lupis)

2012 ◽  
Vol 50 (No. 9) ◽  
pp. 411-414 ◽  
Author(s):  
Z. Ozudogru ◽  
D. Ozdemir
Keyword(s):  
Renal Artery ◽  
Renal Arteries ◽  
Left Renal Artery ◽  
Dorsal Branch ◽  
Corrosion Cast ◽  
The Right ◽  
Segmental Arteries

Study of the intrarenal arterial pattern of kidney by a corrosion cast method was carried out on 10 kidneys of wolves. The left renal artery was longer than the right one. The renal arteries divided into two dorsal and one ventral branches. The dorsal branches were longer and thinner than the ventral one. Both dorsal and ventral branches gave off the interlobar, arcuate and interlobular arteries, respectively. The right dorsal branch gave off 5&ndash;7 segmental arteries, the right ventral branch 4&ndash;5 segmental arteries, the left dorsal branch 6&ndash;9 segmental arteries and the left ventral branch 7&ndash;8 segmental arteries. No anastomoses were observed between the renal arteries and their branches.

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