Clinical Insight into the Precaval Right Renal Artery: A Multidetector Row Computed Tomography Angiographic Study

Abstract

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.

Paraaortic Lymphadenectomy in Gynecologic Oncology—Significance of Vessels Variations

“…Authors reported prevalence of precaval RRA of 5.48%. They concluded that the incidence of precaval RRA appeared to be more frequent than previously thought [49]. Yeh et al came to the same conclusion as they reported incidence of 5% of the artery.…”

“…It had a preaortic and precaval course [50]. Moreover, our experience and the observation of the majority of authors demonstrated that the additional LRA typically arises from the left lateral aspect of the AA (Figures 10 and 11) [28,[44][45][46]49].…”

“…An addi-tional RRA mostly arises from the anterolateral surface of the AA or sometimes from the right CIA. In cases of additional right RAs, vessels often pass anterior to the IVC (Figures 8 and 9) [28,[44][45][46]49]. Jeffery reports a case of a 65-year-old woman with additional LRA arising from the LRA and entering the lower pole of the right kidney.…”

“…During surgery, oncogynecologists should be aware of this vessel's variation, if they observe hydrouereter without obvious cause for its occurrence [44]. Furthermore, ligation of additional aortic polar RAs is associated with segmental ischemia and failure of the kidney, as these arteries are end arteries and cause an infarction of approximately 30% of the renal parenchyma [46][47][48][49][50][51]. Eitan et al reported an additional aortic lower polar RRA injury during PALND for endometrial cancer.…”

Precaval Right Renal Arteries with Circum-aortic Left Renal Vein

“…The incidence of precaval right renal arteries which has been reported in the literature variesfrom 5.0%-9.17% [2][3][4]. Rameshbabu et al in a MDCT angiographic study, reported a prevalence of 8.88 % [5].…”