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[Arterial blood supply of horseshoe kidneys with special reference to percutaneous lithotripsy]
K H Künzel1, H Schlocker, G Janetschek
1Institut für Anatomie, Universität Innsbruck.
The arterial blood supply of six horseshoe kidneys has been examined in respect to percutaneous lithotripsy, i.e. puncture of the renal pelvis in its dorsolateral aspect including nephroscopic extraction of renal calculi. The blood supply of horseshoe kidneys is presupposed by evolution. Besides the definitive renal arteries there are accessory arteries which may be regarded as persistent mesonephric arteries. We distinguish between proper accessory arteries entering the horseshoe kidney at its hilum and aberrant accessory arteries which reach either the upper extremities or the zone of fusion. The latter derive form the abdominal aorta or the bifurcation respectively, the common iliac arteries, the left renal artery, the inferior mesenteric artery or the median sacral artery. Despite the variability of the renal arteries we didn't find any larger vessels in the area of puncture. The anatomical investigations showed that there is no increased risk of hemorrhage performing percutaneous lithotripsy on horseshoe kidneys. During the last two years 8 patients with horseshoe kidneys have been operated because of relapsing calculi using this method, showing no intra- or postoperative complications.
The arterial blood supply of six horseshoe kidneys has been examined in respect to percutaneous lithotripsy, i.e. puncture of the renal pelvis in its dorsolateral aspect including nephroscopic extraction of renal calculi. The blood supply of horseshoe kidneys is presupposed by evolution. Besides the definitive renal arteries there are accessory arteries which may be regarded as persistent mesonephric arteries. We distinguish between proper accessory arteries entering the horseshoe kidney at its hilum and aberrant accessory arteries which reach either the upper extremities or the zone of fusion. The latter derive form the abdominal aorta or the bifurcation respectively, the common iliac arteries, the left renal artery, the inferior mesenteric artery or the median sacral artery. Despite the variability of the renal arteries we didn't find any larger vessels in the area of puncture. The anatomical investigations showed that there is no increased risk of hemorrhage performing percutaneous lithotripsy on horseshoe kidneys. During the last two years 8 patients with horseshoe kidneys have been operated because of relapsing calculi using this method, showing no intra- or postoperative complications.