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Volume: 4 Issue: 2 December 2006 - Supplement - 1

FULL TEXT

PERI-HILAR BRANCHING PATTERN OF THE RENAL ARTERY

The peri-hilar branching pattern of the renal arteries is very important for surgeons to know before the kidney transplantation. The literatures on this topic are more often than not single case reports. To our knowledge, no series has yet been done to show this anatomy. The aim of this study was to identify the variations in the peri-hilar (extra-parenchymal) branching of the main renal artery. Eighty one kidneys of 65 potential renal transplant donors who had undergone pre-operative conventional renal angiography at our center were randomly recruited and examined. Renal shadow was marked on the film and the main renal artery traced from its origin medially up to their entrance into the renal parenchyma. Morphologically, we classified the peri-hilar branching pattern of the main and segmental arteries into ladder (with sequential branching points) and fork (with a common branching point) types. The latter was either duplicated or triplicated. The peri-hilar morphology of the main renal artery was then categorized according to its primary and secondary divisions and their patterns. If a single category encompassed more than or equal to the 5% of observed figures, it was recorded as a “cardinal” perihilar arterial morphology. Otherwise, it was counted within the category of 'others'. At the level of main artery, fork pattern was observed in 93.8.1% (n = 76) (84.3% duplicated (n =64) and 15.7% triplicated (n = 12)) and ladder pattern in 6.2% (n = 5) of kidneys. Of 165 branches off the fork-type main artery, a secondary division was found in 73.2% (n = 120). Only one secondary division (4%) was noted from a ladder-type main artery. Eight “cardinal” peri-hilar renal arterial morphologies were detected that constituted 82.7% (67 out of 81) of all cases. At least ten “other” infrequent morphologies were also found. These patterns showed a significant alteration with the presence of a supernumerary renal artery. Peri-hilar branching pattern of the main renal artery is of high individual variability. We believe the results of this study may be useful for the surgeons operating at the renal hilum especially for the kidney transplantation.



Volume : 4
Issue : 2
Pages : 152


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