The variation of renal artery anatomy in the Iraqi population: An angiographic study of 358 middle Euphrates Iraqi patients attending the catheterization laboratory in Hilla province

Abstract

Objective: the aim of this study is to determine the prevalence and the rate of renal artery variations in the middle Euphrates Iraqi population.Materials and methods : Three hundred fifty eight (358) patients were referred to Shaheed Al Mihrab Cardiac Centre in Hilla province for a variety of indications for catheterization including ischemic heart disease , lower limb peripheral arterial disease , valvular heart disease , etc , detailed information about the angiographic procedure was given, an informed consent was obtained ,all patients renal arteries were visualized by either selective engagement using Judkins RT catheter or non selectively using a pig tail catheter .Results : Anatomically the origin of the main renal artery was at the level of the first lumbar vertebra (L1) in 62% , L1-L2 disk in 13% ,L2(22%) of the cases , the remaining 3% was distributed over the T12 ,T12-L1 ,L2-L3 ,L3, L4 vertebral levels .The renal artery bifurcates at the hilum into the segmental arteries in 56.7% of the cases , in the remaining 43.3% ,the renal artery bifurcates in to segmental arteries before it reaches the hilum and at variable distance from it aortic origin .Each kidney was supplied by a single renal artery on both side in the same patients in 79.8% of the cases while in the remaining 20.2% there was more than one renal artery in the following ratios :unilateral dual blood supply on the LT kidney (10%), RT kidney (6.5%) ,bilateral dual blood supply on both sides (2.5%) and in 1% of the cases there was more than two arteries on either side .we recorded one case four renal arteries on the left kidney , and there was triple renal arteries bilaterally in another one case .Conclusion: Renal artery anatomical variation is common in the general population and this study confirms a nearly comparable frequency of variations in the Iraqi population with some diversion from the comparable studies that might be explained on racial bases.