A lower polar additional renal artery in an ectopic intraperitoneal kidney

Background: The kidneys are positioned retroperitoneally and they are normally supplied by the paired renal arteries. We describe a long left additional renal artery which supplies the lower pole of an intraperitoneal, labile, and smaller than usual left kidney, a variation that might complicate uroradiological procedures or surgery and cause failure of lithotripsy. Material and methods: The reported anatomical variations were discovered during routine educational dissection in a female cadaver. Results: The left kidney was found inside the parietal peritoneum (intraperitoneal), and it was lying free among the small bowel loops, without any underlying supportive tissues. Moreover, it was smaller than it should have been (length: 9.3 cm, diameter 3.1 cm) and possessed a lower polar additional left renal artery rising from the lateral side of the abdominal aorta, passing posterior to the ureter, and which was rather long (length: 8.8 cm). At the right side we did not find any variations of the renal region. Conclusions: Such a variation should be taken into consideration as it may lead to complications or explain some of them, if they occur. (Folia Morphol 2011; 70, 1: 56-58

An unusual case of asymmetrical combined variations of the subclavian and axillary artery with clinical significance

In a Greek Caucasian male cadaver, a combination of the following arterial variations were observed: an aberrant right subclavian artery originating as a last branch of the aortic arch and coursed posterior to the oesophagus, a right non-recurrent laryngeal nerve, an atypical origin of the left suprascapular artery from the axillary artery, an unusual emersion of the lateral thoracic artery from the subscapular artery and a separate origin of the left thoracodorsal artery from the axillary artery. According to the available literature the corresponding incidences of the referred variants are: 0.7% for the aberrant right subclavian artery, 1.6–3.8% for the origin of the suprascapular artery from the axillary artery, 3% for the origin of the left thoracodorsal artery from the axillary artery and 30% for the origin of the lateral thoracic artery from the subscapular artery. Such unusual coexistence of arterial variations may developmentally be explained and has important clinical significance

An aperture in the sagittal plane of the dorsal wall of the sacrum

The dorsal wall of the sacrum presents various anatomical variations, while the dorsal bony wall of the sacral canal suffers more. We report a case of a sacrum with a series of variants in the midline due to abnormal ossification and a bizarre aperture on the sagittal plane between the 1st and the 2nd sacral spinous processes. A failure of the ossification patter during embryological life, or an ossification of the supraspinous ligament may result in such an aperture. Sacrum variety is of great importance for the daily proper medical practice

Vertebral artery variations revised: origin, course, branches and embryonic development

Background: The vertebral artery originates from the subclavian artery and is divided into four segments. The aim of this study is to investigate the anatomical variations in the course and branches of the vertebral artery. Materials and methods: A research was performed via PubMed database, using the terms: “variations of vertebral artery AND cadaveric study”, “variations of vertebral artery AND cadavers” and “anomalies of vertebral artery AND cadavers”. Results: A total of 24 articles met the inclusion criteria, 13 of them referring to variations of the origin of the vertebral artery, 9 to variations of the course and 3 to variations of its branches. On a total sample of 1192 cadavers of different populations, origin of the left vertebral artery directly from the aortic arch was observed at 6.7%. In addition, among 311 cadavers, 17.4% were found with partially or fully ossified foramen of the atlas for the passage of the vertebral artery, while the bibliographic review also showed variants at the exit site of the artery from the transverse foramen of the axis. Conclusions: Despite the fact that variations of both the course and the branches of vertebral artery are in most cases asymptomatic, good knowledge of anatomy and its variants is of particular importance for the prevention of vascular complications during surgical and radiological procedures in the cervix area

Anatomical study of the common iliac arteries

Background: The common iliac arteries (CIA) are the two terminal branches of the abdominal aorta which supply the pelvis and the lower extremities. The present study aims to examine the morphometric features of the CIA in a cadaveric sample and possible correlations between lengths.Materials and methods: Seventy-six formalin fixed cadavers of Greek origin were dissected in the Department of Anatomy, School of Medicine, National and Kapodistrian University of Athens. In each cadaver dissected, the abdominal aorta and the CIA were identified and their lengths were measured. Also the torso length was measured and the height of each cadaver. All the statistical analysis was done by SPSS 15.0.Results: The mean length of the left CIA was 6.12 cm (SD: ± 1.791, SE: 0.205) and that of the right one was 6.03 cm (SD: ± 1.607, SE: 0.184). The lengths of the CIA differed between the sexes, but no statistically significant difference was observed. Statistically significant differences regarding the torso lengths and body heights were found between the sexes, as well as a statistically strong correlation between the lengths of the left and right CIA in the cadavers dissected.Conclusions: The knowledge of the anatomy and morphology of the CIA is ofgreat clinical significance, given that abnormal course, length or branching pattern of these vessels are not uncommon and their clinical impact may be great. Mostly interventional radiologists and vascular surgeons should be aware of this knowledge

Case series and a systematic review concerning the level of the aortic bifurcation

Background: The aim of this study is to present the level of aortic bifurcation in a sample of Greek origin (case series) and to perform an up-to-date systematic review in the existing literature. Materials and methods: Seventy-six formalin-fixed adult cadavers were dissected and studied in order to research the level of aortic bifurcation. Additionally, PubMed and Google Scholar databases were searched for eligible articles concerning the level of aortic bifurcation for the period up to February 2020. Results: The mean level of aortic bifurcation according to our case series was the lower third of the L4 vertebral body (21/76, 27.6%). The level of aortic bifurcation ranged between the lower third of the L3 vertebral body and the lower third of the L5 body. No statistically significant correlation was found between the two sexes. The systematic review of the literature revealed 31 articles which were considered eligible and a total number of 3537 specimens were retracted. According to the recorded findings the most common mean level of aortic bifurcation was the body of L4 vertebra (1495/3537 cases, 42.2%), while the range of aortic bifurcation was described to occur from upper third of L3 vertebrae to the upper third of the S1 vertebrae in the 52.8% of the cases (1866/3537). Conclusions: The mean level of AA corresponds to the body of L4 and presents a great range (form L3U to S1U). Knowledge of the mean level of aortic bifurcation and its probable ranges is of great significance for interventional radiologists and especially vascular surgeons that deal with aneurism proximal to the aortic bifurcation

Dependence of contact area on the resolution of fractal interfaces in elastic and inelastic problems

Purpose - The purpose of this paper is to investigate the influence of the resolution with which interfaces of fractal geometry are represented, on the contact area and consequently on the contact interfacial stresses. The study is based on a numerical approach. The paper focuses on the differences between the cases of elastic and inelastic materials having as primary parameter the resolution of the interface. Design/methodology/approach - A multi-resolution parametric analysis is performed for fractal interfaces dividing a plane structure into two parts. On these interfaces, unilateral contact conditions are assumed to hold. The computer-generated surfaces adopted here are self-affine curves, characterized by a precise value of the resolution delta of the fractal set. Different contact simulations are studied by applying a horizontal displacements on the upper part of the structure. For every value of s, a solution is taken in terms of normal forces and displacements at the interface. The procedure is repeated for different values of the resolution delta. At each scale, a classical Euclidean problem is solved by using finite element models. In the limit of the finest resolution, fractal behaviour is achieved. Findings - The paper leads to a number of interesting conclusions. In the case of linear elastic analysis, the contact area and, consequently, the contact interfacial stresses depend strongly on the resolution of the fractal interface. Contrary, in the case of inelastic analysis, this dependence is verified only for the lower resolution values. As the resolution becomes higher, the contact area tends to become independent from the resolution. Originality/value - The originality of the paper lies on the results and the corresponding conclusions obtained for the case of inelastic material behaviour, while the results for the case of elastic analysis verify the findings of other researchers

Bilateral origin of the testicular arteries from the lower polar accessory renal arteries [Origen bilateral de las arterias testiculares desde las arterias renales polares inferiores accesorias]

The gonadal arteries (testicular or ovarian arteries) emerge normally from the lateral aspect of the abdominal aorta, a little inferior to the renal arteries. Several other sites of origin of these arteries have been recorded with the renal and accessory renal arteries being the most common. In the present case report, the testicular arteries originated from the lower polar accessory renal arteries in both sides. The testicular veins followed had the usual origin and course, while an accessory renal vein was observed only in the right side. These anomalies were combined with an abnormal left ureter exiting from the lower pole of the kidney. Only one male cadaver among 77 adult human cadavers of Caucasian origin presented this set of variations (frequency: ≤ 1.3%). Variations of renal and gonadal vessels are important, as their presence could result in vascular injury of any accessory or aberrant vessel if the surgeon does not identify them

A morphometric study concerning the branching points of the main arteries in humans: Relationships and correlations

An adequate quantity of data on the branching points and important arterial segments of the main arteries in humans is missing. Moreover, a suitable data collection and thereby observed correlations might provide some important clues relating to angiogenesis issues.Thus, we chose to examine in sixty-two embalmed human cadavers of Hellenic origin:. 1. The vertebral levels of origin and the angle from the sagittal plane of the unpaired visceral aortic branches, the renal arteries, and the aortic bifurcation. 2. The lengths of the celiac, common iliac, common femoral and brachiocephalic arteries. 3. The distances between the origins of all the above mentioned arteries, the subsclavian, vertebral and profunda brachii arteries.The level and angles of the branching points did not differ substantially from similar data, mentioned in the literature. Our results revealed that symmetry exists between the limbs and the aortic length and the branching positions of the abdominal aorta. The aortic length is negatively related to the length of both common iliac arteries. The lengths of the celiac and the brachiocephalic artery (correlated weakly with one another) presented fewer correlations, while the segment between the inferior mesenteric and the celiac artery was correlated with other segments from different locations mainly on the right side. This last distance, the aortic length, the distance between the celiac and inferior mesenteric arteries, the length of both common femoral arteries differed significantly according to gender, independently of body length and height.Our data support the view that the final position and length of the arteries might be due to the location of the corresponding viscera during angiogenesis, to the body length and height and to some (hypothetical) elongation angiogenetic factors. © 2010 Elsevier GmbH

Study of the ascending lumbar and iliolumbar veins: Surgical anatomy, clinical implications and review of the literature

The surgical anatomy (geometrical features, metric relations, and drainage pattern) of the ascending lumbar vein (ALV) and iliolumbar vein (ILV) is clinically important. Notwithstanding, the available literature comprises but a small number of studies and a limited number of specimens involved. The present study constitutes a detailed description and classification of the drainage pattern of both these veins. The detailed anatomy of ALV and ILV was examined in both sides in 59 embalmed adult human cadavers of Caucasian origin. Cases with anatomical variations (9 cadavers) of the inferior vena cava (IVC), common iliac vein (CIV), external iliac vein (EIV) and internal iliac vein (IIV) were excluded from subsequent study and analysis. In the remaining 50 cadavers (100 sides) two main drainage types of the lower end of ALV were found. In Type I (54%, 54/100) the ALV presented the same pattern in both sides. In Type II, the ALV differed in pattern from one side to the other (46%, 46/100). Four subtypes were recorded for each Type. An ALV-ILV common trunk occurred in 15% (15/100). The percentage of variations of ALV was 34% and ILV 91%. The number of variations of the two veins differed significantly (p< 0.001). No statistically significant difference was found relating to side or gender. Thorough knowledge of the surgical anatomy of ALV and ILV prevents injury, bleeding and further complication of many operations in the retroperitoneal space and pelvis. Awareness of the geometrical features of ALV and ILV helps avoiding or aids early recognition of a misplacement of a vascular catheter into the ALV during femoral vein catheterizations. © 2011 Elsevier GmbH