Correlation between Renal Artery Anatomy and Hypertension: A Retrospective Analysis of 3000 Patients

Objective. To assess the correlation between renal artery anatomy and blood pressure in Undiagnosed Hypertension and Diagnosed Hypertension. Methods. The renal artery CT scanning imaging data and laboratory data of 3000 inpatients and outpatients were collected retrospectively in 4 centers of China. Morphometric parameters were assessed using the quantitative vascular analysis (unit: mM). Results. 687 cases (23.2%) had accessory renal arteries unilaterally, and 216 cases (7.3%) had bilateral accessory renal arteries, including left kidney 825 (27.9%) and right kidney 798 (27.0%). The presence of accessory renal arteries and renal artery branches was higher in the diagnosed hypertension group as compared with the undiagnosed hypertension group (MARB, p p < 0.001; ARA, p < 0.001; others, p < 0.001). Consequently, multivariate regression analysis showed that age (OR = 2.519 (95% CI: 0.990–6.411, p < 0.001)), dyslipidemia (OR = 1.187 (95% CI: 0.960–1.454, p = 0.007)), renal hilum Outside the main renal artery branch (MRAB) (OR = 2.069 (95% CI: 1.614–2.524, p = 0.002)), and accessory renal artery (ARA) (OR = 2.071 (95% CI: 1.614–2.634, p = 0.001)) were risk factors of hypertension. In addition, higher renin activity was associated with ARA patients (2.19 ± 2.91 vs. 1.75 ± 2.85, p < 0.001). Conclusions. When comparing renal arteries side by side, the anatomical length of the renal arteries is significantly different. In addition, the prevalence of accessory renal arteries and renal artery branches is higher in the hypertension group. The auxiliary renal artery and the main renal artery branch outside the renal portal are independent factors of hypertension. Renal sympathetic nerve activity is affected by renin activity and is related to the accessory renal artery.

Cadaveric Study of Anatomical Variations of Renal Arteries

Introduction: Anatomical variations of renal artery are important to prevent complications during renal transplant surgery or renal angiography. Of this additional renal artery is the most common. Materials and methods: The present study was conducted in 80 kidneys of 40 adult human cadavers in Department of Anatomy, Siddhartha Medical College, Vijayawada over a period of 4 years (2017 to 2021) during educational dissections. Results: Accessory renal arteries are observed in the present study. Origins of these accessory renal arteries are noted along with their entry point into the kidneys. These results were compared with previous studies. Conclusion: Prior knowledge of these variations is important to prevent complications during surgical and angiographic interventions. Keywords: Renal arteries, Accessory renal artery, Aberrant renal artery, Upper pole, Lower pole, Hilum.

SUPERSELECTIVE EMBOLIZATION OF THE RENAL ARTERIES AS A MONOTHERAPY OF KIDNEY TUMOR IN A PATIENT WITH HIGH ANESTHESIOLOGIC RISK

Introduction: Renal artery embolization is a minimally invasive X-ray endovascular operation that is used in the treatment of various urological diseases. This operation is of increasing interest due to its ability to occlude not only proximal, but also distal renal vessels with a low risk of complications. Recent developments in endovascular technology make embolization one of the effective and safe methods applicable to stop renal bleeding, preoperative preparation for surgical treatment of renal malignant tumors, and first-line treatment for angiomyolipomas. For a certain category of patients, renal artery embolization is practically no alternative method of treatment. This applies to comorbid patients with kidney tumors and aggravated somatic status, in whom the anesthetic risk makes open or laparoscopic surgical treatment impossible, and embolization can reduce symptoms, improve the quality of life of such patients and prolong the patient's life.Clinical case: we demonstrate the experience of X-ray surgical treatment of cT1aN0M0 left kidney cancer in an 80-year-old patient.Conclusion: Embolization of renal arteries in some cases can be an effective and safe alternative treatment for renal cell carcinoma in somatically burdened patients who cannot perform surgical treatment.

Review of the article "First experience of superselective embolization of renal arteries supplying the tumor with subsequent laparoscopic kidney resection"

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Renal Artery Stenosis, Diagnosis and Management: a Literature Review

Peripheral arterial atherosclerosis, i.a., in renal arteries, is quite a regular pathology. Despite long clear aetiology and pathogenesis, a unified systemic management approach in such patients is still lacking. We have reviewed and analysed classical academic resources and scientific record databases (Cochrane Library, PubMed and Google Scholar) in the topic and engaged self-experience on the observation and treatment of patients with stenotic peripheral arteries. Ultrasonic duplex scanning (USDS) of renal arteries is the most accessible and cost-effective screening method to date. Among non-invasive techniques are magnetic resonance imaging (MRI) and contrast-enhanced multislice computed tomography (MSCT). Subtraction angiography remains the gold standard for deciding a surgical treatment, and intravascular diagnostic capacities grow as well. Today’s interventional radiology is powered by fractional flow reserve (FFR) measurement, intravascular ultrasound (IVUS) and optical coherence tomography (OCT).The management of patients with narrowed renal arteries remains relevant and requires further insight. A continuing accumulation and synthesis of experience in diagnosis and treatment of peripheral arterial stenosis is imperative. Current medicine relies on high technologies in the discovery and treatment of peripheral arterial stenosis. The quality of patient management directly relates to the hospital technical and financial level, the personnel competence and mastery of current state-of-the-art.