Surgical Importance of Arterial Segments of Human Kidneys: An Angiography and Corrosion Cast Study

Rani, Neha; Singh, Seema; Dhar, Pushpa; Kumar, Rahul

doi:10.7860/jcdr/2014/7396.4086

Cited by 15 publications

(12 citation statements)

References 3 publications

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“…Neerja Rani et al [9] identified variations in origins of segmental arteries. They observed the anterior division gave four branches apical, upper, middle and lower segmental arteries.…”

Section: Resultsmentioning

confidence: 99%

A Radioanatomical Study on Cadaveric Kidneys to Trace the Course of Polar Arteries to Kidneys

Rao¹,

Meera²,

Sujatha³

et al. 2016

IJAR

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The segmental arteries of the kidneys arise from the anterior and posterior divisions of the main renal artery. These segmental arteries branch into lobar and then into interlobar arteries. At the junction of the cortex and medulla they dichotomize into arcuate arteries. Interlobular arteries branch off at right angles from the arcuate arteries. The present study was attempted to find out the course taken by the polar arteries, whether they have a specific area of blood supply and whether they contribute to any anastomoses in the cortex with other arteries or whether they end in the cortex separately. Results: 12 kidneys out of the 52 kidneys had arteries which entered the upper pole of the kidneys. The arteries that entered the upper poles took origin from the main renal artery proximal to the origin of anterior segmental artery and went to the poles directly from outside the hilum. The course of the artery was traced through radiological procedure and found that they entered the substance of the kidney and no traces of anastomoses could be made out. The terminal capillaries could not be traced in this particular method of study. Therefore it was not possible to find out if the polar arteries gave rise to interlobular arteries after they entered the poles of the kidneys. Conclusion: The study did not find any anastomoses with the other arteries in the segment. The polar arteries ended in the substance of the kidney. Though it was not possible to trace if they divided into interlobular arteries in this study it has potential for research in the future to detect any disturbance in the kidney functions of those who have polar arteries. If the polar arteries were to end in the cortex would they contribute to a capsular network that results in increase in the formation of stellate veins which drain into interlobular veins and therefore increase the venous drainage of the kidneys? Will such an arrangement affect the counter current exchange mechanism?

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“…Neerja Rani et al [9] identified variations in origins of segmental arteries. They observed the anterior division gave four branches apical, upper, middle and lower segmental arteries.…”

Section: Resultsmentioning

confidence: 99%

A Radioanatomical Study on Cadaveric Kidneys to Trace the Course of Polar Arteries to Kidneys

Rao¹,

Meera²,

Sujatha³

et al. 2016

IJAR

View full text Add to dashboard Cite

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“…Although exposure to the concept of variation usually occurs early in training and primarily through dissection courses [31], many of the region/organ details are often revisited within clinical clerkships and during residency training [32]. For example, variations in renal arterial patterning may have little clinical significance unless they are coupled with hypertension or require mapping for clinical procedures such as surgical resection (e.g., [33]), transplantation (e.g., [34]), or percutaneous access (e.g., [35]). Given the multisystem (i.e., arterial, venous, and ureteral) involvement, this case clearly demonstrates the anatomical aspect of this concept.…”

Section: Discussionmentioning

confidence: 99%

A Case Study of Malrotated Kidneys with Asymmetric Multiple Renal Arteries, Variant Venous Drainage, and Unilateral Ureteral Duplication

Dunnwald

Pizzimenti

2019

Case Reports in Vascular Medicine

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Variations in the arterial, venous, and ureteral patterning of the right (r) and left (l) kidneys are common; however, concomitant involvement with all three systems is rare. Specimens that demonstrate anatomic variation across multiple systems provide an opportunity to illustrate links between anatomic concepts, embryologic development, clinical practice, and education. During anatomic study of the abdominal cavity, a total of five major arteries (3l and 2r) emerged from the aortic and common iliac axes in a cadaveric donor. Through continued study, multiple contributing veins, of different caliber, coalesced into four major renal veins (2l and 2r) that returned blood from the kidneys to the inferior vena cava (IVC) at different locations. In addition, unilateral duplication of the kidney with concomitant ureters was evident on the right side. Both ureters continued inferiorly and independently entered the bladder, each with an observable orifice adjacent to the bladder trigone. Most evident in the specimen was the anteriorly directed hilum for both kidneys. Reported measures for each of the observed anatomic variations suggest that the current specimen has an estimated incidence of less than 0.3%. This comparatively rare specimen provides an example of important anatomic concepts that are relevant to educational and clinical practices.

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“…If possible, continuous renal parenchyma bleeding should be treated with DSA and selective embolisation as an alternative to surgery (figure 2). 4–6 For that reason, knowledge about the renal artery branching pattern is very important 12. Grade 4–5 injuries usually require additional procedures.…”

Section: Discussionmentioning

confidence: 99%

Traumatically shattered kidney without urine extravasation or vascular amputation

et al. 2015

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SUMMARYThe American Association for the Surgery of Trauma (AAST) injury scoring scale is commonly used for genitourinary injuries. Normally, grade 4-5 lacerations of the kidney show involvement of the pelvicalyceal system (PCS) with urine extravasation (UE). We present a case of a 41-year-old woman who was hospitalised with macrohaematuria and retroperitoneal haematoma after severe blunt acceleration flank trauma. CT scan showed an extended laceration of the left kidney with separation of upper pole. This is the first case of an extended kidney laceration without UE due to rupture within the dichotomous PCS, which healed up after selective embolisation. If possible, severe renal bleeding should be treated with selective embolisation as an alternative to surgery. Any suspected involvement of the PCS should undergo retrograde ureteropyelography and urinary diversion. BACKGROUND

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Surgical Importance of Arterial Segments of Human Kidneys: An Angiography and Corrosion Cast Study

Cited by 15 publications

References 3 publications

A Radioanatomical Study on Cadaveric Kidneys to Trace the Course of Polar Arteries to Kidneys

A Radioanatomical Study on Cadaveric Kidneys to Trace the Course of Polar Arteries to Kidneys

A Case Study of Malrotated Kidneys with Asymmetric Multiple Renal Arteries, Variant Venous Drainage, and Unilateral Ureteral Duplication

Traumatically shattered kidney without urine extravasation or vascular amputation

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