Use of Spiral Computerized Tomography in Lieu of Angiography for Preoperative Assessment of Living Renal Donors

Kaynan, Ayal M.; Rozenblit, Alla M.; Figueroa, Katherine; Hoffman, Saul; Cynamon, Jacob; Karwa, Gattu Lal; Tellis, Vivian A.; Lerner, Seth E.

doi:10.1097/00005392-199906000-00006

Cited by 13 publications

(22 citation statements)

References 8 publications

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“…It has major clinical implications in practice and it contributes to the safety of renal and retroperitoneal surgery. 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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“…[1][2][3][4][5] The potential value of MR angiography for preoperative evaluation has also been shown. 8,16 Halpern et al 9 compared contrast-enhanced helical CT angiography using single detector-row helical CT and contrast-enhanced 3D MR angiography for the preoperative evaluation of kidney donors.…”

Section: Discussionmentioning

confidence: 99%

“…Both computed tomography (CT) angiography and magnetic resonance (MR) angiography are increasingly accepted methods, thus replacing conventional catheter angiography DSA, for preoperative evaluation of living renal donors. [1][2][3][4][5][6][7][8][9] Halpern et al 9 compared the efficacy of contrastenhanced helical CT angiography using single detector-row helical CT and contrast-enhanced threedimensional (3D) MR angiography for the preoperative evaluation of kidney donors. Their results showed substantial agreement between these two modalities but disagreement in the interpretation of small arteries.…”

Section: Introductionmentioning

confidence: 99%

Evaluation of renal arteries in living renal donors: comparison between MDCT angiography and gadolinium-enhanced 3D MR angiography

et al. 2006

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“…In successfully treated patients, the ratio of renal artery peak systolic velocity to aortic peak systolic velocity (ie, renal-aortic ratio) decreases to less than 3.5, a value that classifies the diameter stenosis as less than 60% [30]. • Computed tomographic angiography is a highly sensitive imaging modality that has been used for preoperative assessment of living related kidney donors [31]. Maximum-intensity projection reconstructions permit a firm diagnosis in 95% of patients [32].…”

Section: Diagnosismentioning

confidence: 99%

Fibromuscular dysplasia

Slovut¹,

Olin

2005

Curr Treat Options Cardio Med

193

100

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The most common clinical manifestations of fibromuscular dysplasia (FMD) are hypertension due to renal artery involvement and transient ischemic attack or stroke due to carotid or vertebral artery involvement. Patients with renal artery FMD and hypertension should undergo primary angioplasty with the goal of curing the hypertension. If the blood pressure fails to normalize following angioplasty, the physician should institute antihypertensive medications according to the recommendations of the Joint National Committee on the Prevention, Detection, and Treatment of High Blood Pressure VII. In patients with cerebrovascular FMD, antiplatelet agents represent the cornerstone of therapy. Percutaneous angioplasty has emerged as the preferred treatment for symptomatic cerebrovascular FMD.

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Use of Spiral Computerized Tomography in Lieu of Angiography for Preoperative Assessment of Living Renal Donors

Cited by 13 publications

References 8 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

Evaluation of renal arteries in living renal donors: comparison between MDCT angiography and gadolinium-enhanced 3D MR angiography

Fibromuscular dysplasia

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