Mompeo Blanca, Maranillo Eva, Garcia-Touchard Arturo, Larkin Theresa, Sanudo Jose
Department de Morphology, Universidad de Las Palmas de Gran Canaria. Las Palmas, Spain.
Department of Human Anatomy and Embryology, University Complutense of Madrid, Madrid, Spain.
Clin Anat. 2016 Jul;29(5):660-4. doi: 10.1002/ca.22720. Epub 2016 Apr 19.
Catheter-based renal denervation techniques focus on reducing blood pressure in resistant hypertension. This procedure requires exact knowledge of the anatomical interrelation between the renal arteries and the targeted renal nervous plexus. The aim of this work was to build on classical anatomical studies and describe the gross anatomy and anatomical relationships of the renal arteries and nerve supply to the kidneys in a sample of human cadavers. Twelve human cadavers (six males and six females), age range 73 to 94 years, were dissected. The nervous fibers and renal arteries were dissected using a surgical microscope. The renal plexus along the hilar renal artery comprised a fiber-ganglionic ring surrounding the proximal third of the renal artery, a neural network along the middle and distal thirds, and smaller accessory ganglia along the course of the nerve fibers. The fibers of the neural network were mainly located on the superior (95.83%) and inferior (91.66%) surfaces of the renal artery and they were sparsely interconnected by diagonal fibers. Polar arteries were present in 33.33% of cases and the renal nerve pattern for these was similar to that of the hilar arteries. Effective renal denervation needs to target the superior and inferior surfaces of the hilar and polar arteries, where the fibers of the neural network are present. Clin. Anat. 29:660-664, 2016. © 2016 Wiley Periodicals, Inc.
基于导管的肾去神经技术专注于降低顽固性高血压患者的血压。该手术需要精确了解肾动脉与目标肾神经丛之间的解剖学相互关系。本研究的目的是在经典解剖学研究的基础上，描述人类尸体样本中肾动脉的大体解剖结构以及肾脏的神经供应和解剖关系。解剖了12具人类尸体（6男6女），年龄在73至94岁之间。使用手术显微镜解剖神经纤维和肾动脉。肾门肾动脉周围的肾丛包括围绕肾动脉近端三分之一的纤维神经节环、沿中间和远端三分之一的神经网络以及沿神经纤维走行的较小的副神经节。神经网络的纤维主要位于肾动脉的上表面（95.83%）和下表面（91.66%），它们通过对角纤维稀疏地相互连接。33.33%的病例存在极动脉，其肾神经模式与肾门动脉相似。有效的肾去神经需要针对肾门和极动脉的上、下表面，这些部位存在神经网络的纤维。《临床解剖学》2016年第29卷：660 - 664页。© 2016威利期刊公司。
