Variations in Renal Artery in Egyptian Population: Cadaveric and Angiographic Study

Abstract
Background: Variations of Renal Artery (RA) are impor-tant in uroradiological procedures. Pre-operative visualization of the renal vascular anatomy is crucial for selecting the proper kidney during renal transplantation and avoiding vascular injuries.
Aim of Study: The present study aimed to describe RA variations and different branching patterns in a section of Egyptians using dissected cadavers and Multi Detector Com-puted Tomography Angiography (MDCTA).
Subjects and Methods: The study included 207 renal pedicles (7 kidneys and 100 CT images). The specimens were examined for morphological patterns of RA. MDCTA images were evaluated for the level of origin, length, caliber and presence of additional renal arteries.
Results: The renal arteries in the dissected specimens showed fork (duplicate and triplicate) and ladder patterns. The level of origin of RA in MDCTA images was at L1 (52%), L2 (32%), L1-L2 intervertebral disc (11%), T12-L1 interver-tebral disc (3%), T12 (1.5%) and L2-L3 intervertebral disc (0.5%). The mean caliber of the left RA was greater than the right RA (left 6.99±1.47mm, right 6.55±1.51mm, p=0.003). Out of 200 renal pedicles, 21 (10.5%) additional arteries were observed in the form of 13 (6.5%) accessory renal arteries, 2 (1%) aberrant superior polar arteries, 2 (1%) superior polar arteries, 3 (1.5%) aberrant inferior polar arteries and 2 (1%) dual renal arteries. The most commonly seen branching pattern was the hilar (82%), followed by prehilar (11.5%) then inta-parynchymal branching pattern (6.5%).
Conclusion: Variations of RA are common in Egyptian population. The most important are the presence of additional arteries and different branching patterns. Variations in renal vasculature in relation to population should be taken in consideration during urological interventions.