Caryn Recto, Maria Boddi, Jacopo Junio Valerio Branca, Gabriele Morucci, Alessandra Pacini, Massimo Gulisano, Ferdinando Paternostro

Variations in the branching pattern of the aortic arch are clinically relevant because of the direct influence that their presence can have on the success of cardio-vascular procedures, neck or thorax surgery, trauma management or intensive care. In most cases these anatomical variations are asymptomatic and considered clinically benign, but some particular aortic branching patterns have been associated with surgical complications or with vascular diseases in non-surgical patients.

The main objective of this work was to study the frequency of variation of the aortic arch branching pattern in a wide and varied population on the basis of literature reports.

The aortic arch branching pattern of 20,030 cases reported by 40 anatomical or radiological studies were analyzed. 84,52% of the studied population had a three branches pattern and 14,65% had a two branches pattern.

The four primary arteries were seen arising directly from the aortic arch in 0,81% of the cases and only 0,02% had them all arising from a common trunk.

IJAE Vol. 124, n. 1: 5-15, 2019
https://oajournals.fupress.net/index.php/ijae/article/view/1692/1690

Caryn Recto, Antonino Marcello Pilia, Riccardo Campi, Jacopo J.V. Branca, Alessandra Pacini, Ferdinando Paternostro

Introduction: vascular anatomy variations are important in academic, clinical and surgical are-as as well as nephrology, urology, oncological and vascular surgery, among others. The main objective of this review is to know the real prevalence of multiple renal arteries in a wide, mul-tiethnic population. Secondary objectives are to establish the prevalence of early branching of the renal artery and the prevalence of these variations in left and right kidneys.

Methods: this study analyzes the renal arterial anatomy of 20.782 kidneys from 64 anatomical and radiologi-cal studies.

Results: Multiple renal arteries (MRA) were present in 19,95% of the total kidneys, in number of 2 to 6 arteries arriving to the hilum. The most frequent number of MRA was 2 renal arteries (89,48%), followed by 3 (9,31%), 4 (1,06%), 5 (0,02%) and 6 (0,005%). This last one being found in only one kidney. Reported data on the lateralization of the MRA are rather poor, and among these no side’s predilection was found: MRA were found in 49,83% on the right side and 50,17% of left kidneys. Early branching patterns were described in only one third of the published data, being present in 11,4% of the total kidneys from those data (corresponding in 4,23% of right kidney cases and in 4,52% of left kidney cases; 2,66% had no right/left infor-mation).

Discussion: the most difficult part was to merge the results from the different studies due to the heterogeneity of their descriptions. A universally accepted medical nomenclature is needed in order to allow a more precise lecture and transmission of results in clinical practice. Renal anatomical variations have clinical and surgical implications in renal transplantation, cor-rectable hydronephrosis, ablation treatment for refractory hypertension or endovascular recon-structions and should be taken into account by every physician.

IJAE Vol. 124, n. 2: 153-163, 2019
https://oajournals.fupress.net/index.php/ijae/article/view/10776/10696