MSCT Angiography in Estimation of Anatomic Variants of Kidney Artery

Anatomical variants of the renal vessels both arteries and veins occur quite often. Reliable knowledge of vascular anatomy is a significant aspect in the planning of surgical interventions. The purpose of this study was visualization of variants of kidneys vascular systems, and presentation of reconstructions of variants of arterial blood supply of the most frequently occurring kidneys. Traditional angiography is still considered the golden standard for the study of anatomy of the abdominal cavity vessels. However, the development of multidetector spiral computed tomography (MSCT), in combination with the methods of digital image reconstruction, provided the possibility of angiography without the need for invasive angiographic techniques that present a certain risk to the patient together with an opportunity to assess the anatomical and functional status of kidneys and adjacent organs. The results of visual research methods are the most important tool in planning surgical interventions such as nephritis, pyeloplastics, kidney transplantation, and others. Possession of complete anatomical information may influence the choice of the surgical treatment method. Taking into account the increase in the number of organ-saving operations in neonates and kidney transplants, the need for a more detailed visualization of the anatomy of the regional vascular bed of the kidney and its variants has increased. In the planning of renal resection, information about anatomy of the vessels is vital. Reducing the time of warm ischemia is one of the technical factors of the operation, which can improve the functional outcome. The difference in such cases will be the temporary imposition of the clamping on the segmental artery instead of the main, which improves the function of the kidneys in the early postoperative period. The possibility of creating a three-dimensional model of the vascular bed of the kidney with the help of MSCT allows a more precise application of a surgical technique. When a kidney transplant is from a living donor, the identification of a single renal artery is a positive factor and reduces the number of complications. The blood supply variants increase the number of thrombosis, prolong the time of warm ischemia, increase blood loss, complicate the implementation of anastomosis. They also increase the risk of fistulas and ureter formations development. However, the anatomical variants of blood supply do not affect the level of rejection of the graft after 1 year and 5 years of observation.