English

Abstract

Renal artery variations are more important for surgeons and clinicians. As these variations alter and influence the surgical procedures including intervention methods. These variations are associated with physiological and embryological changes which will alter the medical treatment. The present work is conducted in the department of anatomy, Andhra medical college, Visakhapatnam for 50 cadavers for a period of 3 years. In one case 3 additional renal arteries arising from abdominal aorta one on right, two on left side were found. INTRODUCTION: The renal arteries usually arise from the abdominal aorta just below the origin of superior mesenteric artery, laterally or antero laterally (Williams).1,2 Renal artery variations are more frequently reported than other large vessels. Graves(1956)3 described variations regarding renal arteries as an (a)accessory where arteries arise from abdominal aorta in addition to main renal arteries. (b) aberrant arising from sources other than abdominal aorta. Incidence of pre caval right renal arteries varies from 0.8% (Petit. P)4 to 5% Yeh et al.5 suggested that most of precaval right renal arteries were accessory lower polar arteries. In 2008 SHOJA.M.M et al.6 described prehilar pattern of renal artery. The embryological explanation of these variations has been presented and discussed by Keibel F & Mall F7. Accessory renal arteries are found frequently on the left side. Their occurrence is as high as 30-35% of the cases. These arteries usually enter the upper or lower pole of the kidneys (Singh G, NGYK, Bay BH)8. According to kadir et al.9 accessory renal arteries are of two types. The most common first type is where the accessory renal arteries enter into the renal hilum along with the main renal artery, the other type is where the accessory arteries enter directly into the capsule of polar regions. Ozkan et al.10 named second group of accessory renal arties as polar or aberrant arteries. There are a few other renal vascular variations that must be differentiated from the accessory renal arteries (Netter FH, Shapter RK, Yonkman F F)11. Opinion of earlier authors differ in regard side of accessory renal arteries, some authors have reported a high frequency on the left side (Saldarriaga. B, Perez. AZ)12 while others (Nayak, Budhiraja)13, 14 reported it to be more frequent on the right side. Lower polar arteries which typically pass in front of ureter are associated with a relatively higher incidence of hydronephrosis resulting from obstructions of ureter in uretro pelvic region (Anson.BJ)15. The right renal artery that passes ventral to the inferior vena cava is important for pre surgical planning, because chances of injury especially during retroperitoneal approach are high when only the right gonadal vein is expected to lie in pre caval area. This anterior origin may also result in misidentification of vessels during laparoscopy, such as the inferior mesenteric, superior mesenteric or hepatic artery. OBJECTIVES: Identification of anomalous vascular supply to the kidneys and their anatomical relationship to abdominal aorta and inferior vena cava and to represent their interpretation in surgical procedures. DOI: 10.14260/jemds/2014/2016