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. 2023 Apr 11;9(4):e15315.
doi: 10.1016/j.heliyon.2023.e15315. eCollection 2023 Apr.

Anatomical variability of kidney arterial vasculature based on zonal and segmental topography

Edgar S Kafarov  1 , Ilia Miltykh  2 , Andrey V Dmitriev  3 , Oleg K Zenin  2
Affiliations

Anatomical variability of kidney arterial vasculature based on zonal and segmental topography

Edgar S Kafarov et al. Heliyon. .

Abstract

Introduction: To date, there is no unified approach to the lobar, zonal, and segmental structure of the kidney vasculature. There is no recognizable approach to define basic characteristics in regard to the lobes and segments identifying of the kidney. The branching of the renal artery has often been the subject of scientific research. This study aimed to analyze the arterial anatomy on the basis of zonal and segmental topography.

Materials and methods: This study is a prospective cadaver study on autopsy material using corrosion casting and CT imaging techniques. The arterial vasculature was visualized using corrosive casting. In this study, 116 vascular casts were included. We identified the number of arteries in the kidney hilum, their topography, branching variations of the renal artery, and local blood supply zones of renal masses considering second- and third-order renal artery branches. We used a micro-CT BRUKER SkyScan 1178, digital camera, Mimics-8.1, and R.

Results: This study has shown that RA divides into two or three zonal arteries, forming a two- or three-zonal vascular supply system. In the case of the two-zonal system, 54.3% of cases accounted for RA branching into ventral and dorsal arteries, whereas 15.5% of cases referred to superior polar and inferior polar zonal arteries. The three-zonal system implies 4 types of RA branching: 1) superior polar, ventral, and dorsal zonal branches (12.9%); 2) ventral, dorsal, and inferior polar zonal branches (9.5%); 3) two ventral and one dorsal zonal branches (5.2%), and 4) superior polar, central, and inferior polar zonal branches (2.5%).

Conclusions: The results of this research make us reconsider Grave's classification theory.

Keywords: Renal segments; Segmental renal arteries; Zonal arteries.

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Conflict of interest statement

The authors declare no conflict of interest.

Figures

Fig. 1
Fig. 1
Corrosion Casts of Renal Arterial Vasculature. a. Two-zonal branching (male, 58 years); b. two-zonal branching (male, 53 years); c. three-zonal branching (female, 59 years); d. three-zonal branching (male, 72 years); e. three-zonal branching (female, 73 years); f. three-zonal branching (male, 76 years): ZS, zonal arterial segment; p, presegmental arterial segment; s, segmental arterial segment. 360° videos of corrosion casts are available at https://miltykh.com/RAbranching/.
Fig. 2
Fig. 2
Schemes of Branching Patterns. a. VD_7S branching type (two-zonal system); b. SpIp_6S branching type (two-zonal system); c. SpVD_7S branching type (three-zonal system); d. VDIp_7S branching type (three-zonal system); e. SvIvD_10S branching type (three-zonal system); f. SpCIp_8S branching type (three-zonal system): ZS, zonal arterial segment; p, presegmental arterial segment; s, segmental arterial segment, sb, small branches. 360° videos of corrosion casts are available at https://miltykh.com/RAbranching/.
Fig. 3
Fig. 3
Pooled proportions (%) with 95% confidence intervals (CIs) of two (a) and three-zonal (b) renal artery branching. RE Model – Random Effects model.
See this image and copyright information in PMC

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