Evaluation of renal vascular variations with multi-section CT angiography

Evaluation of Renal Vascular Variations with Multi-Section Ct Angiography INTRODUCTION AND OBJECTIVE: Knowing the presence of variations in renal vascular structures reduces the complication rates of renal donor nephrectomy and interventional endovascular procedures. Renal vascular variations may be the underlying cause of renovascular hypertension, varicocele and pelvic varicose veins. The aim of our study is to determine the frequency and association of these variations. MATERIAL AND METHOD: A total of 610 abdominal CT examinations, which were performed in the radiology unit of our hospital between 01.01.2016 and 10.10.2019, were evaluated retrospectively in terms of renal artery and renal vein variations. 60 patients were excluded from the study due to technical factors or situations related to the patient (such as solitary kidney, horseshoe kidney, tumor invasion, renal transplant), which complicated or completely prevented the examination of renal vascular structures. 550 patients (301 men, 249 women) were included in the study. Abdomen CT examinations screened for renal artery variations (hilar and polar accessory renal artery, early branching renal artery, precaval right renal artery), left renal vein variations (retroaortic left renal vein, circumaortic left renal vein, multiple left renal vein, late junction), right renal vein variations (multiple right renal vein, involvement of gonadal vein into right renal vein, late junction). RESULTS: The frequency of renal vascular variation was 44.2%. Renal artery variation is seen with a frequency of 28.3%, while renal vein variations are seen with a frequency of 26.5%. The most common renal artery variation is the right hilar accessory renal artery (35/550, 6.3%), while the most common renal vein variation is the right multiple renal vein (39/550, 7.1%). The coexistence of renal artery and vein variations was found to be 10.7%. The most common coexistence of renal artery and vein variation were found to be right hilar accessory renal artery-right multiple renal vein, right hilar accessory renal artery-left circumaortic renal vein (5/550, 0.09%). There was a statistically significant relationship between renal artery variation and renal vein variation (p<0,001). It was found that the rate of right hilar accessory renal artery, left polar accessory renal artery and late junction of left renal vein was significantly higher in men than in women (p: 0,003, p: 0,006, p:0,014). CONCLUSION: Renal vascular variations are seen in 44.2% of the population. In addition, the arterial and venous variations show a substantial coexistence, such as 10.7%. It should be known that its presence is extremely important before endovascular interventional procedures and surgical procedures and during the investigation of renovascular hypertension, pelvic varices and varicocele etiology. MDCT is the most appropriate and non-invasive method to evaluate this. Key Words: Renal vascular variation, renal artery, renal vein, CT angiography