Utility of 16-MDCT Angiography for Comprehensive Preoperative Vascular Evaluation of Laparoscopic Renal Donors

Abstract

16-MDCT angiography enabled excellent preoperative detection of arterial anatomy and venous laparoscopic donor nephrectomy.

Can renal dimensions and the main renal artery diameter point to the presence of an accessory renal artery? a 64-slice CT study

“…In the present study, the smallest renal artery diameter found was 1.1 mm, and this value showed that the stated limitation is overcome by MSCT, especially 64-slice CT, due to the availability of the smallest (0.5 mm) thickness (6,7,10). In our study with a larger number of patients, the aRA prevalence of 22.8% was close to the prevalence found in a cadaveric study (2).…”

“…In our study with a larger number of patients, the aRA prevalence of 22.8% was close to the prevalence found in a cadaveric study (2). These findings indicate that MSCT angiography provides results similar to those obtained for the conventional angiography technique (6,10,18,19).…”

“…Knowledge of the arterial anatomy of the kidney, especially prior to surgeries carried out with a small field of view, such as laparoscopic and retroperitoneoscopic nephrectomy, aids in decisions in planning the nephron-sparing surgery and prevents possible perioperative surprises (17,18). For example, a donor kidney without an aRA is preferred because it allows for an easier surgery for both the donor and the recipient (6,18,19). Bleeding due to an invasive procedure performed on an aRA may result in open laparotomy, whereas a missed case of an aRA may cause an infarct in a transplanted kidney and associated hypertension in the recipient (12,17).…”

“…MSCT has a narrow collimation, high spatial and temporal resolutions and nearly isotropic acquisition, and thus, it provides multiplanar imaging. In addition, its level of accuracy is similar to conventional angiography in evaluating renal vascularity (6,7,10). On the other hand, the disadvantages of MSCT are radiation exposure and the dependence on contrast medium.…”

“…The aRA arises as a separate branch from the aorta or iliac artery, and it has been reported with a prevalence of approximately 25-30% in different study groups (1)(2)(3)(4). Determination of the presence of an aRA has major importance in invasive renal procedures, such as laparoscopic or retroperitoneoscopic nephrectomy for living donor kidney transplantation, in the prevention of complications during the procedure or in the preoperative evaluation of patients with renal tumors in whom nephron-sparing surgery can be performed, and finally in the evaluation of renovascular hypertension related to isolated aRA stenosis (4)(5)(6)(7)(8).…”