Evaluation of Renal Artery Variations in Horseshoe Kidneys with Computed Tomography

Objective: Horseshoe kidney is the most common renal fusion anomaly, accounting for 90%. The study aims to explore the variations in the renal arteries of individuals with horseshoe kidney anomalies and contribute to the classification in the literature. Materials and methods: Computed tomography images of 145 individuals who had intravenous contrast-enhanced abdominal computed tomography for any reason and had horseshoe kidney anomalies were analyzed retrospectively, and the presence, origin, and number of accessory renal arteries were evaluated. Then, classification was performed according to the origin of the accessory arteries. Results: In 145 individuals, 44 different combinations of the accessory artery according to the origin and number were obtained. Most common accessory artery combination was type 2a (M1). According to our classification, 13.1% of the patients were type 1, 57.2% were type 2, 17.2% were type 3, 10.3% were type 4, and 1.4% were type 5. Conclusion: The classifications of arterial variations in horseshoe kidney anomalies did not match each other in previous studies and did not comprise all patients because they were conducted with a small number of cases. A more comprehensive new classification was created in our study according to accessory artery origins with the help of previous studies.

[1]  M. Polguj,et al.  The level of origin of renal arteries in horseshoe kidney vs. in separated kidneys: CT-based study , 2018, Surgical and Radiologic Anatomy.

[2]  O. Gupta,et al.  Renal Fusion Anomalies: A Review of Surgical Anatomy , 2015 .

[3]  T. Nishibe,et al.  Evaluation of Renal Artery Anomalies Associated with Horseshoe Kidney Using CT Angiography. , 2015, The Tokai journal of experimental and clinical medicine.

[4]  M. Piagkou,et al.  Horseshoe kidney: a review of anatomy and pathology , 2014, Surgical and Radiologic Anatomy.

[5]  Ş. Yıldız,et al.  Multidetector computed tomography for preoperative evaluation of vascular anatomy in living renal donors , 2009, Surgical and Radiologic Anatomy.

[6]  L. Oğuzkurt,et al.  Renal artery origins and variations: angiographic evaluation of 855 consecutive patients. , 2006, Diagnostic and interventional radiology.

[7]  M. Kaufman,et al.  An unusual case of complete renal fusion giving rise to a ‘cake’ or ‘lump’ kidney , 2001, Journal of anatomy.

[8]  G. Kootstra,et al.  Horseshoe kidney transplantation: an overview , 2000, Clinical transplantation.

[9]  L. Hollier,et al.  Endovascular repair of abdominal aortic aneurysms in patients with congenital renal vascular anomalies. , 1999, Journal of vascular surgery.

[10]  J. Coselli,et al.  The impact of renal fusion and ectopia on aortic surgery. , 1988, Journal of vascular surgery.

[11]  S. Cornell,et al.  The arterial supply of horseshoe kidneys. , 1971, The American journal of roentgenology, radium therapy, and nuclear medicine.

[12]  F. T. Graves The arterial anatomy of the congenitally abnormal kidney , 1969, The British journal of surgery.

[13]  J. Beregi,et al.  Rare variations in renal anatomy and blood supply: CT appearances and embryological background. A pictorial essay , 2001, European Radiology.

[14]  R. May,et al.  Anomalies of the upper urinary tract. , 1956, McGill medical journal.