Multidetector computed tomography for preoperative evaluation of vascular anatomy in living renal donors

Türkvatan, Aysel; Akıncı, Serkan; Yıldız, Şener; Ölçer, Tülay; Cumhur, Turhan

doi:10.1007/s00276-008-0428-0

Cited by 38 publications

(34 citation statements)

References 18 publications

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“…Thin cuts CT scans must remain the gold standard for preoperative assessment before laparoscopic donor nephrectomy, which is the standard of care for the procurement of allografts from potential living kidney donors [4,5,12]. This noninvasive imaging modality has a sensibility and accuracy of 100% for the detection of accessory arteries and major renal venous variants (multiple veins, circum-or retro-aortic left renal vein) [13].…”

Section: Discussionmentioning

confidence: 99%

Anatomic variations of the renal vessels: focus on the precaval right renal artery

Bouali

Labarre²,

Molinier

et al. 2011

Surg Radiol Anat

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The aim of this study was to determine the prevalence of precaval right renal artery and to investigate the distribution of renal arteries and veins. We discuss a theory of development of renal vascular variants. We retrospectively reviewed 120 arterial phase contrast material-enhanced spiral computerized tomography scans of the abdomen (1- to 2-mm section thickness) performed during a two-month period. Forty percent of the study group (48 patients) had one artery and one vein on each side, with typical course. There was a 9.17% prevalence of precaval right renal artery: 10 patients had a lower pole accessory artery in precaval position and one patient had the main and the accessory arteries that pass anterior to the inferior vena cava. In these cases, associated variations of renal vessels were higher than in the patients without precaval artery variant. There were multiple arteries in 28.3% of the right kidneys and in 26.7% of the left ones. Variants of the right renal vein consisted in multiple veins in 20% (24 cases). We detected no case of multiple left renal veins, but we described variations of its course (circum- or retroaortic vein) in 9.17% (11 cases). Twenty-six patients (21.7%) had associated variations of the renal pedicle. The current technical support allows for a minimally invasive study of vessels anatomy. In our study the prevalence of a precaval right renal artery appears to be higher than previously reported (9.17%). Knowledge on anatomical variations of right renal artery and associated renal vessels variations has major clinical implications.

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Section: Discussionmentioning

confidence: 99%

Anatomic variations of the renal vessels: focus on the precaval right renal artery

Bouali

Labarre²,

Molinier

et al. 2011

Surg Radiol Anat

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show abstract

“…Additional arteries can, in turn, be divided into two categories according to how they attain the kidney: hiliar, entering at the hilium, and polar, reaching at the pole [39]. Multiple renal arteries can be seen in one-third of patients.…”

Section: Renal Arteriesmentioning

confidence: 99%

“…Gonadal veins are 2–3 mm in diameter on average, growing up to 10 mm (mostly in post partum women). A gonadal vein with a significant diameter should be reported because the surgeon may need to use a different ligation procedure instead of cauterisation [39, 41]. …”

Section: Other Vesselsmentioning

confidence: 99%

Angio CT assessment of anatomical variants in renal vasculature: its importance in the living donor

et al. 2013

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BackgroundRenal vasculature is known for having a broad spectrum of variants, which have been classically reported by anatomists.MethodsThe distribution and morphology of these variations can be explained by considering the embryology of the renal vessels. With the recent outburst of imaging techniques, it has been the radiologist’s turn to take the baton, recognising and describing unconventional renal vascular patterns.ResultsKnowledge of these patterns has gained significance since the advent of the era of transplantation. For almost 60 years cadaveric donation has been the main source of kidneys suitable for transplantation. Living kidney donation demonstrates many advantages and stands out as the best alternative for organ procurement to meet the increasing demand. Since the dawn of laparoscopic nephrectomy as the technique of choice for organ procurement in living kidney donors, MDCT plays a key role as a noninvasive preoperative planning method for anatomic evaluation. As the field of view at laparoscopic surgery is limited, it is essential to meticulously assess the origin, number, division and course of arteries and veins.ConclusionAwareness of the different anatomical variants allows the radiologist to enlighten the surgeon in order to avoid compromising the safety of the surgical procedure that could lead to significant complications.Teaching PointsRenal vasculature has many variants, which can be explained by considering the embryology of kidneys.Living kidney donation demonstrates many advantages over cadaveric donation.Angio CT evaluation of living kidney donors is a multiple phase study.A detailed report describing the variants, their distribution and morphology will help surgeons.

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“…Therefore, among the controllable factors, the type, amount, and injection speed of the contrast agent could be made uniform; namely, in most cases, a total of 80-150 mL nonionic contrast agent is used at an injection speed of 3-4 mL/s, and the main difference lies in the length of the delayed scanning time and the determination of the time point. At present, there are three alternative techniques for selecting the delayed scanning time and determining the time point (Türkvatan et al, 2009;Yap et al, 2010;Koplay et al, 2010;Kim et al, 2011;Kulkarni et al, 2011;Bazeed et al, 2011). 1) Method 1-empirical value method: according to the experience value, the scan is performed in 25 and 50 s to show arteries and veins, respectively.…”

Section: Discussionmentioning

confidence: 99%

Application value of multislice spiral computed tomography angiography in the evaluation of renal artery variation in living donor kidney transplantation

Xiu-yi¹,

Tian²,

Ru³

et al. 2015

Genet. Mol. Res.

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ABSTRACT. This study aims to investigate the accuracy and value of multislice spiral computed tomography (MSCT) angiography in the evaluation of renal artery variation in living donor kidney transplantation. Two hundred seventy-three kidney transplantation donors underwent preoperative MSCT scanning. Two doctors determined the running direction and variation of the renal artery through joint analysis of the preoperative original MSCT image and the recombination image using the blind reading method, compared the imaging results with the intraoperative results, and evaluated the accuracy and application value of MSCT angiography in the evaluation of renal artery variation in living donor kidney transplantation. CT angiography (CTA) can better show the renal artery and its variation. A total of 52 accessory renal arteries were found in the 273 kidney transplant operations, whereas 55 accessory renal arteries were found in preoperative MSCT. Four accessory renal arteries indicated in the MSCT were not found during the operation, and one accessory renal artery found during the operation Renal artery variation in donor kidney transplantation was not indicated in the preoperative MSCT. The sensitivity, specificity, positive predictive value, negative predictive value, and accuracy of MSCT in the diagnosis of accessory renal arteries were 98.1, 98.2, 92.7, 99.5, and 98.2%, respectively. MSCT angiography can sensitively and accurately show the renal artery and its variation in living donor kidney transplantation, and has important clinical value for the formulation of the operative scheme before the transplantation.

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Multidetector computed tomography for preoperative evaluation of vascular anatomy in living renal donors

Cited by 38 publications

References 18 publications

Anatomic variations of the renal vessels: focus on the precaval right renal artery

Anatomic variations of the renal vessels: focus on the precaval right renal artery

Angio CT assessment of anatomical variants in renal vasculature: its importance in the living donor

Application value of multislice spiral computed tomography angiography in the evaluation of renal artery variation in living donor kidney transplantation

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