A Cadaveric Study on the Anomalous Origin of Renal and Gonadal Vasculature: An Observational Study

Authors

DOI:

https://doi.org/10.5195/ijms.2022.757

Keywords:

Renal Transplantation, Congenital Abnormality, Medical Imaging, Dissection

Abstract

Background: Due to the increasing prevalence of kidney transplantation, a greater awareness of variations in the surrounding vasculature is of surgical importance. During embryological development, both the renal and gonadal arteries arise from lateral mesonephric branches of the dorsal aorta. In adults, gonadal arteries are paired vessels that normally arise from the aorta at the level of the second lumbar vertebra.

Methods: Routine cadaveric dissection completed by first-year medical students and dental students incidentally revealed anatomical anomalies.

Results: We describe two cadaveric findings in male cases which demonstrate unilateral and bilateral variations of testicular arteries originating from an aberrant renal artery in one case and an accessory renal artery in the other.

Conclusion: By increasing awareness of anomalous testicular arteries we hope to encourage the standardization of preoperative vasculature exploration to both minimize intra-operative risk to living male kidney donors and increase patients’ understanding of potential risks and complications prior to consenting to the procedure providing more accurate information prior to surgery.

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References

Hart A, Lentine KL, Smith JM, Miller JM, Skeans MA, Prentice M, et. al. OPTN/SRTR 2019 Annual Data Report: Kidney. Am J Transplant. 2021;21 Suppl 2:21-137.

United States Renal Data System [Internet]. 2020 [cited 2021 Sep 26]. USRDS Annual Data Report: Epidemiology of kidney disease in the United States. National Institutes of Health, National Institute of Diabetes and Digestive and Kidney Diseases, Bethesda, MD, 2020. Available from: https://adr.usrds.org/2020/end-stage-renal-disease/6-transplantation.

Horvat LD, Shariff SZ, Garg AX; Donor Nephrectomy Outcomes Research (DONOR) Network. Global trends in the rates of living kidney donation. Kidney Int. 2009;75(10):1088-98

Perez, JA, Torres FG, Toribio AM, Fernandez LK, Hayoun, C, Naranjo ID. Angio CT assessment of anatomical variants in renal vasculature: its importance in the living donor. Insights Imaging. 2013; 4:199-211.

Sadler, TW. Langman's medical embryology. 14th ed. Philadelphia: Lippincot Williams & Wilkins, 2015.

Cicekcibasi AE, Salbacak A, Seker M, Ziylan T, Buyukmumcu M, Uysal II. The origin of gonadal arteries in human fetuses: Anatomical variations. Ann Anat. 2002;184:275–9.

Machnicki A, Grzybiak M. Variations in testicular arteries in fetuses and adults. Folia Morphol (Warsz). 1997;56(4):277-85.

Notkovich H. Testicular artery arching over renal vein: clinical and pathological considerations with special reference to varicocele. Br J Urol. 1955;27(3):267-71.

Kayalvizhi I, Narayan RK, Kumar P. Anatomical variations of testicular artery: a review. Folia Morphol (Warsz). 2017;76(4):541-50.

Moore KL, Dalley AF. Clinically oriented anatomy. Philadelphia: Lippincott Williams & Wilkins. 1999.

Praveen, Kumar G (2012) Bilateral Superior Accessory Renal Arteries - Its Embryological Basis and Surgical Importance – A Case Report. J Clinic Case Reports 2:e105.

Graves, F.T. The aberrant renal artery. J Anat 1956; 90(Pt 4): 553-8.1.

Tank, PW. Grant's dissector. 15th ed. Philadelphia: Wolters Kluwer Health/Lippincott Williams & Wilkins; 2013.

Petru B, Elena S, Dan I, Constantin D. The morphology and the surgical importance of the gonadal arteries originating from the renal artery. Surg Radiol Anat. 2007;29(5):367-71.

Das, S. Anomalous renal arteries and its clinical implications. Bratisl Lek Listy 2008;109(4):182-4.

Harmath CB, Wood CG 3rd, Berggruen SM, Tantisattamo E. Renal Pretransplantation Work-up, Donor, Recipient, Surgical Techniques. Radiologic clinics of North America. 2016;54(2):217–34.

Kok NF, Dols LF, Hunink MG, et al. Complex vascular anatomy in live kidney donation: imaging and consequences for clinical outcome. Transplantation. 2008;85(12):1760-5.

Aghayev A, Gupta S, Dabiri BE, Steigner ML. Vascular imaging in renal donors. Cardiovasc Diagn Ther. 2019;9(Suppl 1):S116-S130.

Gameraddin, M. Ultrasound of the Kidneys: Application of Doppler and Elastography, Essentials of Abdominal Ultrasound. Books on Demand; 2019.

Gesase, A.P. Rare origin of supernumerary renal vessels supplying the lower pole of the left kidney. Ann Anat. 2007;189(1):53-8.

Kortram K, Lafranca JA, IJzermans JN. Dor FJMF. The need for a standardized informed consent procedure in live donor nephrectomy: a systematic review. Transplantation 2014; 98: 1134–43.

Chan P, Wright E, Goldstein M. Incidence and postoperative outcomes of accidental ligation of the testicular artery during microsurgical varicocelectomy. J Urol. 2005;173(2):482-4.

Hsu CW, et al. Incidence and clinical outcomes of gonadal artery injury during colorectal surgery in male patients. J Gastrointest Surg. 2019; 23: 2075-80.

Gupta R, Gupta A, Aggarwal N. Variations of gonadal veins: embryological prospective and clinical significance. J Clin Diagn Res. 2015;9:AC08–10.

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Published

2022-08-29 — Updated on 2022-10-21

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How to Cite

Farris, P. C., Macciola, D. M., Barazani, L. N., Nathan, J. R., Quinn, D., & Peters, D. F. (2022). A Cadaveric Study on the Anomalous Origin of Renal and Gonadal Vasculature: An Observational Study. International Journal of Medical Students, 10(3), 316–320. https://doi.org/10.5195/ijms.2022.757 (Original work published September 28, 2022)

Issue

Vol. 10 No. 3 (2022)

Section

Case Report

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Copyright (c) 2022 Penelope C. Farris, Dylan M. Macciola, Lauren N. Barazani, Justin R. Nathan, Danielle Quinn, Daniel F. Peters

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