Anatomical variations of the renal arteries: Cadaveric and radiologic study, review of the literature, and proposal of a new classification of clinical interest.

PURPOSE: To analyse the variations of the renal arteries in two samples, cadaveric and computerized tomographic (CT) images, as well as to propose a simple classification of such variations based on the obtained results and an extensive review of the literature on the topic.

MATERIAL AND METHODS: Sixty human dissected kidneys and their vessels, and 583 abdominal CT were studied.

RESULTS: A total of 86 arteries were described in the cadaveric sample, whereas 1223 were analysed in the radiological one. Five types (a-e) and patterns (I-V) have been stablished in the classification. Type a, aortic hilar artery, incidences were 79% in cadavers and 95% in CT; Type b, hilar upper polar artery, incidences were 10% in cadavers and 2% in CT; Type c, aortic upper polar artery, incidences were 5% in cadavers and 2% in CT; Type d, aortic lower polar artery, incidences were 3% in cadavers and 1% in CT; Type e, hilar lower polar artery, incidences were 2% in cadaver and less than 0.1% in CT. The pattern represents the number of arteries reaching one kidney. Patterns I-IV were found in cadavers (I: 78%; II: 19%; III and IV: 2%); in CT sample only patterns I (88%) and II (12%). Pattern V was added because it has been described in the reviewed literature.

CONCLUSIONS: Type a and pattern I are the most prevalent, both in the cadaveric and the CT samples. Also in the consulted literature. There are no differences in the types and pattern incidences by side or sex. A simple, comprehensive and useful classification is proposed.