Variations of course and number of renal vessels are not so uncommon and their knowledge is important for planning of minimally invasive renal surgeries. The earlier literature reports a prevalence of precaval right renal artery between 0.8% and 5%. Normally, the right renal artery passes posterior to the inferior vena cava, but it can also be precaval where it passes anterior to inferior vena cava. The multidetector row contrast enhanced computed tomography angiography allows precise evaluation of renal vasculature. The aim of this retrospective study is to determine the prevalence of precaval right renal artery. Amongst 73 MDCT scans studied, we identified 4 cases of precaval right renal artery with the prevalence being 5.48%, more than what is reported in the earlier literature. We also report a single and dominant precaval right renal artery in one of the cases, which is a rare finding. On the basis of these results, we conclude that precaval right renal artery appears to be more common and so the knowledge of this variant holds a major clinical implication in preventing misinterpretation of radiological images and proper planning of interventional procedures and minimally invasive surgeries.
Introduction:
Embryological development of the aorta being a complex process can lead to a variety of congenital variants. It may result in complications during abdominal laparoscopic and radiological interventions. Prior knowledge can identify the anatomy, which may require special attention at the time of surgery/interventions. Diagnostic imaging with multidetector computed tomography (MDCT) allows accurate and noninvasive preoperative evaluation. To identify and to evaluate the anatomical variation of major arteries branching from the abdominal aorta using MDCT.
Material and Methods:
Five hundred patients of different age groups referred to the Department of Radiodiagnosis, Dayanand Medical College and Hospital, Ludhiana, for MDCT abdomen were included in the study. It was performed on 128-slice MDCT Siemens Somatom Definition AS scan machine.
Results:
The results showed that anatomical variation occurs in a high percentage of patients. In the celiac axis, it occurred in 34.6% of cases, out of which the most common variant was a replaced right hepatic artery (3.7%). Celiacomesenteric trunk was observed in 0.2% of patient. Single renal artery was observed (43.2%) while accessory renal artery in 41.6% and early branching in 15.2%.
Discussion and Conclusion:
Prior knowledge of variations of these vessels can prevent iatrogenic injuries.
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