Renal Arteries Flashcards
Renal Arteries anatomy in terms of location? Think left and right? 3
- From the aorta just distal to the RMA
- RRA comes off anteriolateral aorta and passes posterior IVC
- LRA comes of lateral and posterolateral aorta
20% of kidneys supplied by what?
Duplicated or accessory arteries
Renal arteries divided how in the renal pelvis?
Vessels that lie anterior and posterior to the renal pelvis, each supplying a different segment
How many segments of the renal arteries are there?
- 4 anterior segmental arteries
- 1 posterior segmental arteries
Segmental arteries branch into what?
Interlobar arteries that reach into the parenchyma
Segmental arteries terminate in what?
Arcuate arteries that lie at the cortico- medullary junction
Interlobar arteries branch off what?
Arcuate arteries in the peripheral cortex
What doe we do with the kidney before evaluating vessels? 2
- Assess kidney size and morphology
- Normal is 9-13 cm, can be as small as 8cm
What is the usually approach for interrogation of the renal arteries? 2
- Transverse, anterior, midline
- RRA can usually folow this way, but a coronal approach may be needed to follow the LRA
What factors contribute to the success of the renal artery exam? 3
- Artery depth
- Respiration
- Abdominal gas
What is usually done for renal artery exams in terms of patient prep?
12 hour fast and scanning in the morning possible to study 90% of patients
In terms of interrogation of the renal arteries, it is important to do what?
Assess the entire length of the vessel to avoid missing lesions
What probe is generally used for Renal artery exams?
2.5-3 MHz probe
LRV passes between the aorta and SMV entering what?
The left side of the IVC
LRV receives which veins?
Left suprarenal and left gonadal vein
Which Renal vein is shorter?
RRV is shorter than the left and extended directly to the hilum
The RRV does not accept what?
No tributaries but it is more common to find accessory veins draining directly into the IVC
Suprarenal (proximal) aortic signal has what kind of flow characteristics?
Low resistance, monophasic waveform because it is feeding a low resistance vascular bed up to this point
What is the velocity of the suprarenal (proximal) artery?
80-100 cm/sec
Distal to the renal arteries what happens to the pattern changes?
Pattern changes to a high resistance multiphasic with a reverse flow component
What are some normal flow characteristics of the renal artery? 3
- Normal low resistance
- Early systolic peak/ compliance peak, may be seen on the upstroke to systole
- 74-127 cm/s
What parts of the renal artery do we assess? (With U/S)
Origin, mid, distal
In the renal artery, what is considered abnormal in terms of velocity and stenosis?
> 180 cm/sec, indicates stenosis >60^
What is the renal artery PSV to Aortic PSV ratio (RAR)?
Normally <3.5