scholarly journals Left double polar renal arteries, left triplicate (preaortic, accessory and retroaortic) renal veins associated with extrinsic pelviureteric junction obstruction and posterior nutcracker phenomenon

2021 ◽  
pp. 20200086
Author(s):  
Martin Ian Kamanda
Keyword(s):  
Renal Artery ◽  
Congenital Anomalies ◽  
Renal Arteries ◽  
Vascular Compression ◽  
Single Patient ◽  
Renal Veins ◽  
Renal Vasculature ◽  
Pelviureteric Junction Obstruction ◽  
Nutcracker Phenomenon ◽  
Morphological Anomalies

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.

scholarly journals Intrauterine unilateral single inferior accessory renal artery: a case report

2019 ◽  
Vol 8 (5) ◽  
pp. 2118
Author(s):  
Punya Pratap Singh ◽  
Gahlot Kavita
Keyword(s):  
Case Report ◽  
Renal Artery ◽  
Surgical Management ◽  
Abdominal Aorta ◽  
Renal Arteries ◽  
Anatomic Variations ◽  
Renal Vasculature ◽  
Accessory Renal Artery ◽  
Aorta Aneurysm ◽  
Accessory Renal Arteries

In comparison with other organs, variants of blood supply to the kidneys were always at special attention due to end arteries. Anatomic variations in the renal vasculature are common and occurrence is varying in between 25% to 40%. The most common variation is presence of accessory renal arteries. Accessory renal artery generally diagnosed on abdomen angiography studies or cadaveric dissection. Only few studies or case report of intrauterine detection of accessory renal artery are available in printed and online literature. During a dedicated anomaly scan of 23 week foetus, detection of an accessory renal artery on left side entering kidney in inferior pole courses parallel to main renal arteries and arising from abdominal aorta. Knowledge of the possible anatomic variations and anomalies of the renal arteries like accessory renal arteries are necessary for proper surgical management during renal transplantation, abdominal aorta aneurysm repair, different urological procedures and angiographic procedures. As the various type of vascular and non - vascular interventions increase, knowledge of the different type of variations of the renal arteries is necessary for proper surgical management in the different specialties.

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 An Unusual Course of Segmental Renal Artery Displays a Rare Case of Hilar Nutcracker Phenomenon

2015 ◽  
Vol 2015 ◽  
pp. 1-5 ◽  
Author(s):  
Devendra A. Sawant ◽  
Thomas F. Moore
Keyword(s):  
Renal Artery ◽  
Renal Vein ◽  
Left Renal Vein ◽  
Left Kidney ◽  
Nutcracker Syndrome ◽  
Renal Vasculature ◽  
Renal Disorder ◽  
Nutcracker Phenomenon ◽  
Renal Hilum ◽  
Segmental Renal Artery

Nutcracker phenomenon or renal vein entrapment is classically seen as a compression of renal vein in between abdominal aorta and superior mesenteric artery with patients being asymptomatic or clinically manifested in the form of nutcracker syndrome as proteinuria, hematuria, flank pain, pelvic congestion in women, and varicocele in men. In this report, we are presenting a case of rare variant of nutcracker phenomenon along with brief review of anatomy, pathophysiology, public health, and clinical significance of nutcracker syndrome. On a routine dissection of an adult male cadaver, we noticed an unusual arrangement of the structures at the hilum of the left kidney showing entrapment of renal vein between left anterior inferior and posterior segmental renal arteries. The variation in the course of left anterior inferior segmental renal artery leads to compression of left renal vein at renal hilum. Therefore, we have named this rare abnormal anatomical entity as hilar nutcracker phenomenon. The structures in the right renal hilum are normal. The objective of this paper is to report an unusual but important variant of nutcracker phenomenon and also give collective knowledge of such anatomical variations in renal vasculature that will help in diagnosing and treating such rare renal disorder.

scholarly journals Anatomical variants of Renal vasculature: A study in adults on multidetector Computerized Tomography angiography scan.

2020 ◽  
Vol 27 (01) ◽  
pp. 185-190
Author(s):  
Maria Mohiuddin ◽  
Sadia Sundus ◽  
Iffat Raza ◽  
Mahrukh Kamran ◽  
Hemant Kumar ◽  
...  
Keyword(s):  
Renal Artery ◽  
Asian Population ◽  
Cross Sectional Study ◽  
Renal Arteries ◽  
Radiology Department ◽  
Renal Vasculature ◽  
Cross Sectional ◽  
Accessory Renal Artery ◽  
Study Participants ◽  
Accessory Renal Arteries

Objectives: To determine renal artery variation in adults in a subset of Karachi population by using Multidetector Computed Tomography (MDCT) angiography. Study Design: A cross sectional study. Setting: Dr. Ziauddin Hospital, Radiology Department, Karachi. Period: From January, 2017 to June, 2017. Material & Methods: Study participants were 250 individuals, who were presented to Dr. Ziauddin hospital, Karachi, Distribution, number and morphology of renal artery variation were reported on Multidetector computed angiography (MDCTA). Renal artery variation with side of the kidney and gender were analyzed. Data was analyzed on SPSS version 20 (Statistical Package for Social Sciences). Frequencies and percentages were calculated for renal artery variations. Results: Following parameters were observed. Out of total 250 study participants single renal artery was present in 73.6 % (184) individuals and accessory renal artery was present in 26.4% (66) individuals. Accessory renal arteries (ARA) were present in 13.8% (35) individuals and 12.6% (31) individuals on respectively on right and left sides. Among accessory renal arteries superior polar arteries were present in 14.9% (37) kidneys, hilar arteries in 10.2 % (26) kidneys and inferior polar arteries in 1.3 % (3) kidney. Conclusion: A complete knowledge of renal artery variations is essential for surgeons and interventional radiologist especially during procedures such as renal vascular interventions and renal transplant. Frequency of ARA in our studied population is comparable to Asian population.

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.

Fetal renal artery blood flow – Normal ranges

Ultrasound ◽  
2021 ◽  
pp. 1742271X2110224
Author(s):  
Sonja Brennan ◽  
David Watson ◽  
Michal Schneider ◽  
Donna Rudd ◽  
Yogavijayan Kandasamy
Keyword(s):  
Blood Flow ◽  
Renal Artery ◽  
Interobserver Reliability ◽  
Intraclass Correlation ◽  
Renal Arteries ◽  
Artery Blood Flow ◽  
Flow Measurements ◽  
Prospective Longitudinal Study ◽  
Normal Ranges ◽  
Prospective Longitudinal

Introduction The study objectives were to develop standard charts for fetal renal artery blood flow to define normal ranges and to assess the reliability of the measurements. Methods This prospective, longitudinal study reviewed 72 low-risk singleton pregnancies who had serial ultrasound examinations. Pulse wave Doppler was used to obtain the resistivity and pulsatility indices of the fetal renal arteries. Standard charts of the fetal renal arteries were created using mixed effects modelling and the intra- and interobserver reliability for the renal blood flow measurements was analysed. Results Standard charts of the normal ranges of the renal artery resistive index (RI) and pulsatility index (PI) of the fetal renal arteries were created. The 3rd, 5th, 10th, 50th, 90th, 95th and 97th centiles were calculated. The intraclass correlation coefficient was acceptable for intraobserver reliability (RI = 0.66, PI = 0.88) and poor for interobserver reliability (RI = 0.11, PI = −0.56). Conclusions These novel charts demonstrate the change of the fetal renal artery blood flow during pregnancy. These may be used in clinical practice to detect variations from these normal ranges and be useful in future studies of kidney function projection.

scholarly journals Effects of Renal Denervation from the Intima and the Adventitia of Renal Arteries on Renal Sympathetic Nerve Activity in Dogs: A Comparative Study

Cardiology ◽  
2015 ◽  
Vol 131 (3) ◽  
pp. 189-196 ◽  
Author(s):  
Minfu Bai ◽  
Chaokuan Yang ◽  
Chuanyu Gao ◽  
Xianpei Wang ◽  
Hongzhi Liu ◽  
...  
Keyword(s):  
Treatment Group ◽  
Renal Artery ◽  
Sympathetic Nerve ◽  
Renal Denervation ◽  
Sympathetic Nerve Activity ◽  
Renal Arteries ◽  
Nerve Activity ◽  
Renal Sympathetic Nerve Activity ◽  
Renal Sympathetic Nerve ◽  
Renal Sympathetic

Objectives: This study was designed to observe the efficacy and safety of renal denervation from the inside and outside of renal arteries. Methods: Fourteen beagles were randomly divided into a control group (n = 4) and treatment group (n = 10). One renal artery in every beagle of the treatment group was randomly assigned to an intimal group (10 renal arteries) which underwent percutaneous renal denervation from the inside, and another renal artery was assigned to an adventitial group (10 renal arteries) which underwent renal denervation from the outside by laparotomy. Results: Compared with the intimal group, the renal norepinephrine (NE) concentration in the adventitial group had significantly decreased (p = 0.003) at 3 months postsurgery. Renal artery HE staining showed that the perineurium from the adventitial group appeared thickened. Western blotting showed that renal tissue tyrosine hydroxylase (TH) protein expression in the adventitial group was significantly lower than that in the intimal group (p < 0.01) at 3 months postsurgery. There was a renal artery stenosis and a renal atrophy in the intimal group after 1 month of follow-up. Conclusion: The inhibitory effect on renal sympathetic nerve activity was more effective in the adventitial group than the intimal group, and renal denervation in the former group was safe.

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.

scholarly journals Morphologic and Functional Magnetic Resonance Imaging of Renal Artery Stenosis: A Multireader Tricenter Study

2002 ◽  
Vol 13 (1) ◽  
pp. 158-169
Author(s):  
Stefan O. Schoenberg ◽  
Michael V. Knopp ◽  
Frank Londy ◽  
Sumati Krishnan ◽  
Ivan Zuna ◽  
...  
Keyword(s):  
Magnetic Resonance ◽  
Renal Artery ◽  
Renal Artery Stenosis ◽  
Interobserver Variability ◽  
Renal Arteries ◽  
Artery Stenosis ◽  
Functional Magnetic Resonance ◽  
Cine Phase Contrast ◽  
Contrast Flow ◽  
Phase Contrast Flow

ABSTRACT. The effect of combined morphologic and functional magnetic resonance (MR) imaging on the interobserver and intermodality variability for the grading of renal artery stenosis is assessed. In a randomized, blinded tricenter analysis, seven readers evaluated 43 renal arteries on x-ray digital subtraction angiography (DSA), 3D-Gadolinium MR angiography (3D-Gd-MRA), cine phase-contrast flow measurement (PC-flow), and a combined analysis of the last two. Interobserver variability was assessed for the grading of renal artery stenosis as well as regional vessel visibility. Intermodality variability for stenosis grading was analyzed in cases in which the readers agreed on the degree of stenosis in DSA. DSA had a substantial interobserver variability for the grading of stenosis (mean κ κ 0.64). 3D-Gd-MRA revealed a slightly improved interobserver variability but incorrectly graded 6 of 34 stenoses on a two-point scale (<50%, ≥50%). The combined approach of 3D-Gd-MRA and PC-flow revealed the best (P = 0.0003) interobserver variability (median κ = 0.75) and almost perfect intermodality agreement with DSA (97% of cases). These findings were confirmed in a prospective analysis of 97 renal arteries. The vessel visibility of the renal artery ostium was significantly better in 3D-Gd-MRA than in DSA, whereas the visibility of the hilar and intrarenal vessels was significantly worse (P = 0.0001). A combined morphologic and functional MR examination significantly reduces interobserver variability and offers reliable and reproducible grading of renal artery stenosis based on stenosis morphology and hemodynamic changes. It can be considered a safe and noninvasive alternative for diagnostic DSA in cases that do not require assessment of intrarenal vessels.

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