Variant Anatomy of the Renal Arteries: a Computed Tomography Angiography Study

Abstract

The article discusses variant anatomy of the renal arteries, potentials of three-dimensional modeling and use of these data in clinical practice. Despite a large number of studies based on both morphological and clinical approaches there is no general consensus regarding options for dividing the renal artery, the number of its branches, their topolocalization. This is due to the fact that most of the research studies are based on cadaveric material, fixed and unfixed. It is difficult to apply these data to explain medical conditions and pathologies of particular patients. Computed tomography allows performing in vivo investigation of various morphometric parameters of the renal arteries, and these findings can subsequently be used in disease diagnostics and treatment.The aim of the study was to identify patterns of topography, linear dimensions and variant anatomy of the human renal arteries based on computed tomography angiography (CTA) with three-dimensional modeling, and to apply CTA findings in clinical practice.Material and methods. The study included CTA images of the abdomen of 130 patients, and their threedimensional models. A hardware-software complex "Luch-S" and software complex "Avtoplan" (Russian project) were used to perform morphometric analysis. The diameter of the renal artery mouth, the level of origin of the renal artery mouths, as well as the angles between the renal arteries and the abdominal aorta were analyzed morphometrically and statistically.Results. The authors have developed recommendations how to use three-dimensional modeling of vascular- organ complexes in patients at the stage of preoperative planning and intraoperative navigation in clinical practice. Generated dataset of personalized morphometric data can be applied to teach basic operation techniques involving possible damage to abnormal vessels, as well as training specific surgical procedures involving the kidney and its vessels in a simulation-based surgical clinic.