Surgical importance of arterial segments of human kidneys: an angiography and corrosion cast study.

Abstract

Variations in the arterial supply of human kidney have been observed frequently, either in routine dissections or surgical practice. The main objective of the present study was to describe the arterial segmental pattern of human kidneys and its variation by angiography and corrosion cast techniques. Forty kidneys were washed and a plastic cannula was inserted into renal artery and the omnipaque dye was injected into it and X-ray was taken. The corrosion casts were prepared by injecting coloured acetate butyrate (CAB) granules solution. Five vascular segments of kidney were seen based on the branching pattern of the renal artery by angiography and corrosion cast techniques. The renal artery was divided into anterior and posterior branches. The anterior branch further divided into four branches viz. apical segmental artery (ASA), Upper segmental artery (USA), middle segmental artery (MSA), lower segmental artery (LSA) while the posterior branch continue as posterior segmental artery. The origins of segmental arteries were variable. In 60% cases apical segmental artery (ASA) had common origin with upper segmental artery (USA) while in 40% cases it took origin directly from the main renal artery. Similarly the variations in the origin of the other branches of anterior division of renal artery were observed. The posterior segmental artery (PSA) however was single and comparatively small and supplied the posterior surface of the kidney. The knowledge of the vascular pattern of the kidney is thus important for the purpose of angiography and surgical procedures especially for nephrectomy and kidney transplantation.