Computed Tomography Angiography Assessment of Renal Artery Dimensions and Variations

Abstract

Introduction: Detailed knowledge of renal arterial anatomy is essential for renal transplantation, donor nephrectomy and urological/ endovascular procedures. Computed tomography angiography (CTA) provides accurate, non-invasive visualization of renal artery dimensions and branching patterns. This study is aimed to evaluate renal artery dimensions and anatomical variations using CT angiography in patients undergoing imaging at Bir Hospital, Nepal.

Methods: A descriptive cross-sectional study was conducted at a tertiary care center in Kathmandu from February 2025 to February 2026. A total of 139 adults with normal renal vascular anatomy on contrast-enhanced CTA were included. Renal artery diameters were measured 10 mm from the ostium, and the distance to first branching was recorded bilaterally. Early branching (<2.00 cm) and supernumerary arteries were documented. Statistical analysis was performed using Statistical Package for the Social Sciences version 24.00, with p < 0.05 considered significant.

Results: Mean right and left renal artery diameters were 5.51 ± 0.85 mm and 5.58 ± 0.87 mm, respectively. Early branching was observed in 49/139 arteries (35.30%), more commonly on the right. Supernumerary renal arteries were present in 36/139 patients (25.90%), predominantly left-sided and hilar. Kidney length correlated positively with ipsilateral renal artery diameter (right: r = 0.31, p = 0.0004; left: r = 0.27, p = 0.0015). Age showed no significant association. A significant gender difference was noted only in left renal artery diameter (p = 0.001).

Conclusion: Moderate renal vascular variability was observed, highlighting the importance of preoperative CTA for individualized surgical planning in Nepalese patients.