Abstract

PurposeHorseshoe kidney is a rare congenital anomaly with potential clinical implications. The aim of this study was to determine the number of renal arteries and veins and the level at which the arteries branched off their parental vessels in individuals with horseshoe kidney (HSK) and in persons with separated kidneys (SK).Materials and methodsThe analysis included computed tomography angiography studies of 331 patients (83 HSK and 248 SK). The number of renal vessels and diameters of renal arteries were determined, along with the level at which they branched in relation to other ramifications (four groups of origin were proposed) and their entrance of the vessels to the kidney.ResultsNumber of renal arteries in HSK group was 4.57 ± 1.39 per patient and 2.4 ± 0.43 in SK group (p < 0.0001). The distribution of branching level of renal arteries in HSK group was: I group ~ 57%, II group ~ 27%, III group ~ 15% and IV group < 1%, whereas in SK group the distribution was respectively: I group ~ 99%, II group < 1%, III and IV group − 0% (p = 0.0001). In HSK group, diameter of renal arteries branching above the IMA was 4.61 ± 1.58 mm, as compared with 3.96 ± 1.34 mm for the arteries branching below (p = 0.0004). Number of veins was 566 in SK group (87.70% of kidneys were supplied by single vein) and 323 in HSK group (9.64% kidneys were supplied by two veins) (p < 0.0001).ConclusionIn HSK group, renal arteries significantly more often branch off their parental vessels below the origin of IMA and such vessels are usually smaller.

Highlights

  • Horseshoe kidney is a rare congenital anomaly resulting from abnormal differentiation of the mesonephros

  • The aim of this study was to determine the number of renal arteries and veins as well the level at which arteries branched off their parental vessels, where arteries entered the kidney and where the renal veins originated from in individuals with horseshoe kidney and in persons with separated kidneys

  • A total of 379 renal arteries were identified in the horseshoe kidney group, with 4.57 ± 1.39 arteries per subject on average

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Summary

Introduction

Horseshoe kidney is a rare congenital anomaly resulting from abnormal differentiation of the mesonephros. The number of horseshoe kidneys differs according to various authors, and are supposed to be found in approximately 1 per 400 to 1 per 800 newborns [6, 17, 35, 37]. This implies that surgeons may often deal with this anomaly during the course of their everyday practice. A systematic analysis of horseshoe kidney vasculature would with no doubt facilitate many abdominal and pelvic surgeries, in particular abdominal aortic aneurysm treatment [15], iliac artery angioplasty or bypass surgery [12, 14], renal artery

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