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Year :2018
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Month :
April
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Volume :
7
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Issue :
2
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Page :
RO20 - RO24
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Evaluation of Renal Vascular Anatomy in Prospective Renal Donors Using 128 Slice CT Angiography
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Correspondence Address :
Vedaraju KS, Boobathi Raja G, Ananda M, Jayashri DN,
Dr. Boobathi Raja G,
Resident, Department of Radiodiagnosis,
Bangalore Medical College and Research Institute,
Bengaluru-560002, Karnataka, India.
E-mail: boobathi07@gmail.com
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Introduction: Introduction: 3D spiral CT angiography has become indispensable in numerous clinical settings and one of its important application is the evaluation of renal transplant donors. With the increasing use of laparoscopic nephrectomy, the transplant surgeon has numerous advantages, but at the same time faces additional changes especially if the vascular anatomy is complex. So a pre-operative knowledge of the arterial and venous anatomy is a must to avoid damage to anomalous vessels.
Aim: To map the renal vascular anatomy in prospective renal donors and study the anatomical variants and their prevalence.
Materials and Methods: This was a prospective study conducted from June2016 to June 2017. CT angiography of the renal vessels was done in all prospective renal donors using a 128 slice Philips Ingenuity Core CT scanner. Volume rendered and Maximum Intensity Projections (MIP) were acquired and the renal vessel anatomy was mapped and studied for variations.
Results: Total 150 patients were studied, 66(44%) of them had variations, 41 of them in renal arteries, 20 in renal veins and tributaries, five in both. Accessory renal artery was the most common (25 out of 41). 22 of them had a hilar variant, whereas the rest three had the polar variant. 12 cases of early branching were found, nine of them on the left side. Late venous confluence into the IVC was the commonest venous variant, more on the left side (14 out of 20). Rare variants included two cases of retro aortic left renal vein and one case of circumaortic left renal vein, eight cases of prominent lumbar/gonadal veins, one case of ectopic kidney with the artery arising from the left common iliac artery.
Conclusion: CT angiography proves to be an indispensable tool for assessing the renal vessels thereby avoiding the need for catheter angiography. In our study, 45% of donors had variations. Hence, sound knowledge of the variants and their prevalence is imperative with laparoscopic nephrectomy being the current modality of choice.
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