scholarly journals Bilateral Vascular Variations at the Renal Hilum: A Case Report

2012 ◽  
Vol 2012 ◽  
pp. 1-4
Author(s):  
Naveen Kumar ◽  
Ashwini P. Aithal ◽  
Anitha Guru ◽  
Satheesha B. Nayak
Keyword(s):  
Renal Artery ◽  
Left Kidney ◽  
Left Renal Artery ◽  
Anterior Branch ◽  
Precise Knowledge ◽  
Renal Vessels ◽  
Renal Hilum ◽  
Aberrant Artery ◽  
Vascular Structures ◽  
The Right

Imaging technology with its advancement in the field of urology is the boon for the patients who require minimally invasive approaches for various kidney disorders. These approaches require a precise knowledge of the normal and variant anatomy of vascular structures at the hilum of the kidney in terms of their pattern of arrangement and division. The present paper describes a bilateral anomalous arrangement of the structures at the renal hilum as well as their peculiar branching pattern which is of clinical and surgical relevance. Multiple branching of the renal vessels was observed in both kidneys due to which the hila were congested. The right renal artery immediately after its origin divided into 2 branches. The upper branch represented an aberrant artery whereas the lower branch gave 5 divisions. The left renal artery also divided into 2 branches much before the hilum as anterior and posterior divisions. The anterior branch took an arched course and gave 6 branches. The posterior branch gave 3 terminal branches before entering the renal substance. In addition to anomalous hilar structures, normal architecture of both kidneys was altered and the hilum of the left kidney was found on its anterior surface.

scholarly journals Renal artery stenosis of atherosclerotic etiology – the single kidney surgical recurrence 12 years after nephrectomy

2016 ◽  
Vol 63 (3) ◽  
pp. 251-254
Author(s):  
Maria Daniela Tănăsescu ◽  
◽  
Marcel Pălămar ◽  
Mihai Ovidiu Comşa ◽  
Alexandru Mincă ◽  
...  
Keyword(s):  
Renal Artery ◽  
Renal Artery Stenosis ◽  
Left Kidney ◽  
Secondary Hypertension ◽  
Artery Stenosis ◽  
The Other ◽  
Left Renal Artery ◽  
Arterial Blood ◽  
The Moment ◽  
The Right

Objectives. Renal artery stenosis, as main cause of renovascular secondary hypertension, is mainly caused by atherosclerosis of large vessels and is clinically characterized by resistant or malignant hypertension, impacting the kidney function to various degrees. The present article brings into attention the case of a patient which developed renal artery stenosis on the left kidney, the same condition occurring 12 years later on the right kidney. Material and method. Our patient was initially diagnosed at the age of 48 with complete occlusion of the left renal artery, for which left nephrectomy was performed, while the right artery was normal. Twelve years later she presents with renal artery stenosis on the right kidney, which is treat by stent-angioplasty. Results. After surgery, the patient’s evolution was positive, with amelioration of the laboratory values, in parallel to the arterial blood pressure. Discussions. The probability that, in the moment of diagnosis of renal artery stenosis with progressive evolution to occlusion caused by atherosclerosis, the other artery would be normal, both seen by ultrasonography and angiography, while years later to develop stenosis, is minimal. Up to present, the literature holds little evidence of such similar cases. Conclusions. In the particular case of patients that were diagnosed with severe renal artery stenosis of atherosclerotic origin and had only one of the arteries affected, it is necessary to keep a permanent monitoring, justified by the risk of development of the same pathology to the other artery

scholarly journals Bilateral lateral rotation of the kidneys with their hilum facing laterally (outwards) - Rare anatomical variations

2015 ◽  
Vol 6 (5) ◽  
pp. 82-84
Author(s):  
Vinu Gopinath ◽  
RV Mookambika ◽  
Velayudhan Nair ◽  
Rema V Nair ◽  
KG Mohandas Rao
Keyword(s):  
Left Kidney ◽  
Anatomical Variations ◽  
Lateral Position ◽  
Left Renal Artery ◽  
Anterior Surface ◽  
Medical Sciences ◽  
Lateral Border ◽  
Renal Vessels ◽  
Male Cadaver ◽  
Renal Hilum

Among the variations of the renal system, abnormalities of structure and position of kidney along with the variations of renal vessels are reported most frequently. However, reports on rotational abnormalities and abnormal positions of renal hilum are scanty. During routine dissection of the posterior abdominal wall, laterally rotated kidneys with laterally facing hila were observed in about 60-year-old male cadaver. On right side, the hilum was more on the anterior surface of the organ and right renal vein was emerging almost from the middle of the anterior surface at the lateral edge of the hilum. However, the hilum of the left kidney was observed along the lateral border of the organ and left renal artery was crossing transversely anterior to the kidney forming a loop to reach the hilum. It was also observed that because of the lateral position of the hilum, the renal vessels and pelvis where passing over the anterior surface of the kidney. Rotational variations and abnormal locations of renal hilum are of importance in surgical procedures like percutaneous nephrectomy. Further clinical and surgical importance of the case is discussed in the paper.DOI: http://dx.doi.org/10.3126/ajms.v6i5.12414 Asian Journal of Medical Sciences Vol.6(5) 2015 82-84 

scholarly journals Total occlusion of the abdominal aorta in a patient with renal failure and refractory hypertension: a case report

2015 ◽  
Vol 76 (1) ◽  
Author(s):  
Cinzia Perrino ◽  
Laura Scudiero ◽  
Maria Piera Petretta ◽  
Gabriele Giacomo Schiattarella ◽  
Mario De Laurentis ◽  
...  
Keyword(s):  
Renal Failure ◽  
Renal Artery ◽  
Abdominal Aorta ◽  
Left Kidney ◽  
Fatal Outcome ◽  
Left Renal Artery ◽  
Refractory Hypertension ◽  
Total Occlusion ◽  
Delay In Diagnosis ◽  
The Right

Total occlusion of the abdominal aorta is unusual, and potentially catastrophic. It occurs in patients with advanced atherosclerotic occlusive disease, and can cause severe ischemic manifestations, depending on the site of obstruction. Prompt and appropriate diagnostic and therapeutic approaches are important whenever this condition is suspected, in order to avoid a fatal outcome. The development of a complex network of collaterals may prevent the manifestation of acute ischemic phenomena, and cause a delay in diagnosis and treatment. Here we report the clinical case of a 59-year-old man who was referred to our Department for evaluation of renal failure and refractory hypertension. Ultrasonography and 99mTc-DTPA scintigraphy showed a shrunken, non-functioning left kidney, while CT angiography and aortography showed the complete occlusion of the aorta from below the right renal artery down to the bifurcation of both common iliac arteries, with a critical stenosis of the origin of the right renal artery, an occlusion of the left renal artery as well as of the origin of the inferior mesenteric artery. The patient was referred to the surgery department for aorto-bifemoral bypass surgery and re-implantation of the right renal artery.

scholarly journals Bilateral accessory renal arteries in a fetus: importance for surgical and radiological practice

2015 ◽  
Vol 4 (3) ◽  
pp. 288
Author(s):  
José Aderval Aragão ◽  
Danillo Primo Andrade Santana ◽  
Ellen Caroline da Conceição Brandão ◽  
Viviane Freitas Andrade ◽  
Marianna Ribeiro de Menezes Freire ◽  
...  
Keyword(s):  
Kidney Transplantation ◽  
Renal Artery ◽  
Anatomical Variations ◽  
Vascular Reconstruction ◽  
Renal Arteries ◽  
Left Renal Artery ◽  
Multiple Renal Arteries ◽  
Renal Vessels ◽  
The Right ◽  
Accessory Renal Arteries

<p><strong>Context:</strong> Knowledge of anatomical variations of the renal vessels is considered important, in view of the increasing use of kidney transplantation, vascular reconstruction and imaging methods.</p><p><strong>Objective:</strong> To report on a case of triple right renal artery, and double left renal artery and its clinical-surgical implications.</p><p><strong>Case report:</strong> In a female fetal cadaver of age 30 weeks, multiple renal arteries were observed: triple in the right and double in the left renal artery. All the arteries were hilar and originated from the lateral face of the abdominal aorta. The lengths of the triple renal arteries were 17, 10 and 12 mm respectively for the upper, middle and lower arteries. The lengths of the double arteries were 10 and 12 mm respectively for the upper and lower arteries. There was no extrarenal segmentation.</p><p><strong>Conclusion:</strong> Knowledge of possible variations in the renal arteries may be very useful for radiologists, urologists and vascular surgeons.</p>

scholarly journals UNILATERAL INHIBITION OF THE RENAL SHWARTZMAN PHENOMENON FOLLOWING INJECTION OF BACTERIAL FILTRATE INTO THE RENAL ARTERY

1937 ◽  
Vol 66 (6) ◽  
pp. 755-760 ◽  
Author(s):  
Alan R. Moritz ◽  
David Weir
Keyword(s):  
Renal Artery ◽  
Positive Reaction ◽  
Left Kidney ◽  
Left Renal Artery ◽  
Refractory State ◽  
Renal Changes ◽  
Shwartzman Reaction ◽  
The Right ◽  
Shwartzman Phenomenon ◽  
Made In

A positive Shwartzman reaction, as indicated by thrombosis and focal hemorrhage in one or more organs, was elicited in 19 of 34 rabbits in which the preparatory injection of bacterial filtrate was made into the left renal artery and the reacting injection was made in the ear vein 24 hours later. In 24 of the 34 rabbits the kidneys were undisturbed throughout the duration of the experiment except for the intra-arterial injection of the left. In 12 of these 24 a positive Shwartzman reaction was observed in the uninjected right kidneys. In only 1 of the 24 injected left kidneys were there changes that might be construed as representing a positive Shwartzman reaction. The changes in this kidney consisted of glomerular thrombosis, not associated with hemorrhage or necrosis. The positive renal Shwartzman reactions seen in the right kidneys were similar to those reported by Apitz and Gerber as representing the renal changes occurring as part of a generalized Shwartzman reaction. The retention of the bacterial filtrate of the preparatory injection in the left kidney, by obstructing both vein and artery for 15 minutes, did not lessen the refractory state. The removal of the right kidney prior to the experiment, with the subsequent demonstration that circulation through the remaining left kidney was not impaired by the intra-arterial injection of filtrate, indicated that the refractory state of the injected kidney was not the result of failure of the reacting dose of filtrate to reach the kidney. In the unilaterally nephrectomized rabbits the development of a positive reaction in other organs indicated that the lack of reaction in the kidney represented a local refractory state. No explanation of the phenomenon was disclosed by these experiments.

scholarly journals The Anatomy of Renal Arteries in Adults

2019 ◽  
Vol 0 (0) ◽  
Author(s):  
Dobrivoje Stojadinovic ◽  
Ivana Zivanovic-Macuzic ◽  
Maja Jakovcevski ◽  
Dejan Jeremic ◽  
Marija Kovacevic ◽  
...  
Keyword(s):  
Renal Artery ◽  
Abdominal Aorta ◽  
Average Length ◽  
Renal Arteries ◽  
Left Renal Artery ◽  
Practical Applications ◽  
Mode Of Entry ◽  
Renal Hilum ◽  
Hilar Dissection ◽  
The Right

Abstract Detailed extraparenhymal renal hilar dissection was performed on 110 fixed cadaveric kidneys (60 from male cadavers and 50 from female cadavers). We analyzed the number of renal arteries, angles between renal arteries and abdominal aorta, length and diameter of the renal arteries. Multiple renal arteries were present in 20.9% of cases, with a slightly higher incidence on the right side (21.8%: 20.0%). The angle between the aorta and the RRA varied from 30° to 100° with a mean of 64.1°, while the angle between the abdominal aorta and the LRA was 40° to 115°, with a mean of 67.3°. The external caliber of the RRA at the point of origin from the abdominal aorta was 5 mm to 9.1 mm, with a mean of 6.8 mm. The same caliber of the LRA was 3.7 to 9.6 mm with a mean of 7.0 mm. The average length of the renal artery from the point of origin from the abdominal aorta to the branching point was 36.2 mm for the right renal artery and 30.7 mm for the left renal artery. The average length of the renal artery from the point of origin from the abdominal aorta to the renal hilum was 65.1 mm for the right one and 54.7 mm for the left one. Knowledge of the number of renal arteries, their mode of entry into the kidney, the angles they build with the abdominal aorta, their diameter and length has practical applications in interventional radiology and surgery of the kidney and its environment.

Case 16.4

2014 ◽  
pp. 763-764
Author(s):  
Christine U. Lee ◽  
James F. Glockner
Keyword(s):  
Atrial Fibrillation ◽  
Pulmonary Hypertension ◽  
Renal Artery ◽  
Left Kidney ◽  
Left Renal Artery ◽  
Lower Pole ◽  
The Right

71-year-old woman with gradually increasing dyspnea, atrial fibrillation, and pulmonary hypertension Coronal fat-suppressed postgadolinium 3D SPGR images (Figure 16.4.1) reveal large varicosities replacing much of the right kidney. Note the enlarged left renal artery and vein and varicosities in the lower pole of the left kidney. Axial T1-weighted FSE images (...

A Study of 11C-Benzoate as a Radiopharmaceutical for Renal Imaging

1984 ◽  
Vol 23 (02) ◽  
pp. 75-76
Author(s):  
Q.-M. Ji ◽  
Y.-C. Wang ◽  
J. Zhang ◽  
X.-C. Shi ◽  
Y. Wang ◽  
...  
Keyword(s):  
Benzoic Acid ◽  
Renal Artery ◽  
Uptake Rate ◽  
Gamma Camera ◽  
Radiochemical Purity ◽  
Left Kidney ◽  
Left Renal Artery ◽  
Renal Imaging ◽  
The Right ◽  
Kidney Imaging

Summary 11C-benzoic acid prepared in a radiochemical purity over 90% was studied radiopharmacologically in mice and rabbits. The uptake of 11C-benzoate in ICR mice increased quickly. The ratio of kidney uptake rate to that in other organs reached values between 9 and 55 with a maximum at 10 min after i.v. injection. Gamma camera imaging of rabbits showed that uptake in the kidneys began at 2 min after injection and that activity began to appear in the bladder 4 min later. Rabbits with left renal artery ligature showed no uptake in the left kidney but the right kidney was imaged to the same extent as that of a rabbit without artery ligature. The kidney imaging of 11C-benzoic acid may be a useful method for renal diagnosis.

Derivation of urinary dopamine from plasma dopa

1988 ◽  
Vol 75 (5) ◽  
pp. 515-520 ◽  
Author(s):  
Reuven Zimlichman ◽  
Paul D. Levinson ◽  
Gerald Kelly ◽  
Robin Stull ◽  
Harry R. Keiser ◽  
...  
Keyword(s):  
Urinary Excretion ◽  
Renal Artery ◽  
Left Kidney ◽  
Left Renal Artery ◽  
Plasma Flows ◽  
Arterial Concentration ◽  
Urinary Dopamine ◽  
The Right ◽  
Venous Plasma

1. We estimated the extent to which circulating dopa (3,4-dihydroxyphenylalanine) is the source of urinary dopamine (DA; 3,4-dihydroxyphenethylamine). Tritiated dopa ([3H]dopa) was infused for 90 min into the left renal artery of seven anaesthetized foxhounds, and levels of labelled and unlabelled dopa and DA were measured in the ureteral urine and in the femoral arterial and left renal venous plasma. 2. Only a small percentage of [3H]dopa delivered to the kidneys was excreted as [3H]DA (0.59% from the left kidney, 0.68% from the right); however, the arterial concentration of endogenous dopa (1220 pg/ml) and the renal plasma flows (144 and 141 ml/min by p-aminohippurate clearances) were such that all of the urinary excretion of endogenous DA (about 1 ng/min from each kidney) could be accounted for by uptake and decarboxylation of circulating endogenous dopa. 3. Plasma dopa is the main source of urinary DA.

Ex Vivo Repair of a Renal Artery Saccular Aneurysm in a Living-Nonrelated Donor and Subsequent Successful Kidney Transplantation

2018 ◽  
Vol 52 (6) ◽  
pp. 455-458
Author(s):  
Rogerio A. Muñoz-Vigna ◽  
Javier E. Anaya-Ayala ◽  
Juan N. Ramirez-Robles ◽  
Daniel Nuño-Diaz ◽  
Sandra Olivares-Cruz
Keyword(s):  
Kidney Transplantation ◽  
Renal Artery ◽  
Ex Vivo ◽  
Incidental Finding ◽  
Left Kidney ◽  
Renal Arteries ◽  
Saccular Aneurysm ◽  
Preoperative Imaging ◽  
The Right ◽  
Stage Renal Disease

The use of kidney grafts with aneurysmal disease involving the renal arteries for transplantation is very uncommon and relatively controversial. We herein present the case of a 52-year-old woman who volunteered to become a living-nonrelated donor; during the preoperative imaging workup, a computed tomography angiography revealed a 1.5-cm saccular aneurysm in the left kidney, while the contralateral renal artery was normal. We decided to utilize the left kidney for a 25-year-old male patient with end-stage renal disease, and following the ex vivo repair using the recipient epigastric vessels and saphenous veins, we completed the transplantation in the right pelvic fossa. The postoperative period was uneventful, and at 8 months from the surgery, the graft remains functional. The surgical repair of renal artery aneurysms followed by immediate kidney transplantation is a safe technique and an effective replacement therapy for recipients. The incidental finding of isolated aneurysmal disease in renal arteries should not exclude graft potential availability for transplantation following repair.

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