The Renal Vascular Pedicle: An Anatomical Study of 430 Body-Halves

Pick, James W.; Anson, Barry J.

doi:10.1016/s0022-5347(17)71289-x

Cited by 141 publications

(45 citation statements)

References 22 publications

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“…Left renal vein usually lies anterior to the aorta but in 1.8 – 3.4% cases there is a single LRV in retro-aortic position before entering IVC [4]. This position restricts its mobility, reduces the advantages of its greater length [5] and its compression by aorta predisposes for renal venous hypertension [6].…”

Section: Discussionmentioning

confidence: 99%

Proximal spleno-renal shunt with retro-aortic left renal vein in a patient with extra-hepatic portal vein obstruction: first case report

et al. 2017

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BackgroundPresence of retro-aortic left renal vein poses special challenge in creating spleno-renal shunt potentially increasing the chance of shunt failure. The technical feasibility and successful outcome of splenectomy with proximal spleno-renal shunt (PSRS) with retro-aortic left renal vein is presented for the first time. The patient was treated for portal hypertension and hypersplenism due to idiopathic extra-hepatic portal vein obstruction.Case presentationA twenty year old male suffering from idiopathic extra-hepatic portal vein obstruction presented with bleeding esophageal varices, portal hypertensive gastropathy, asymptomatic portal biliopathy and symptomatic hypersplenism. As variceal bleeding did not respond to endoscopic and medical treatment, surgical portal decompression was planned. On preoperative contrast enhanced computed tomography retro-aortic left renal vein was detected. Splenectomy with proximal splenorenal shunt with retro-aortic left renal vein was successfully performed by using specific technical steps including adequate mobilisation of retro-aortic left renal vein and per-operative pressure studies. Perioperative course was uneventful and patient is doing well after 3 years of follow up.ConclusionsPSRS is feasible, safe and effective procedure when done with retro-aortic left renal vein for the treatment of portal hypertension related to extra-hepatic portal vein obstruction provided that attention is given to key technical considerations including pressure studies necessary to ensure effective shunt. Present case provides the first evidence that retro-aortic left renal vein can withstand the extra volume of blood flow through the proximal shunt with effective portal decompression so as to treat all the components of extra-hepatic portal vein obstruction without causing renal venous hypertension.

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Section: Discussionmentioning

confidence: 99%

Proximal spleno-renal shunt with retro-aortic left renal vein in a patient with extra-hepatic portal vein obstruction: first case report

et al. 2017

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“…the various arterial branches each supply a portion of the kidney without interrelating anastomoses (SCHMAUS & HERXHEIMER 1932, PICK & ANSON 1940. The arterial fields of supply in the kidney are contiguous and unseparated by any intercalary zone (HOU-JENSEN 1930, FUCHS 1931, LOF-GREN 1949.…”

Section: Discussionmentioning

confidence: 99%

Incomplete Angiogram in Selective Renal Angiography

Köhler¹

1963

Acta Radiologica. Diagnosis

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“…The frequency of the single retroaortic vein ranges between 1.7 and 3.4 per cent of cases in autopsy series (12,13,15), while a persistent circumaortic ring has been reported to vary between 6.0 and 16.8 per cent (12,13,15).…”

Section: Retroaortic Renal Veinsmentioning

confidence: 98%

“…communicating vein Communications from the left renal vein to the ascending lumbar and/or azygos vein system have been reported in autopsy studies in 68.8 and 91.5 per cent of cases (3,12). A wide anastomosis is most frequent in patients with a strictly cranially directed flow in the ascending lumbar vein (10).…”

Section: Varicosity Of Left Renal Ascending Lumbarmentioning

confidence: 99%