Aberrant renal vessels crossing the ureter and the ureteropelvic junction: A retrospective computed tomography-based analysis of non-obstructed population
Abstract
BACKGROUND: Crossing renal vessels are recognized as potential extrinsic contributors to ureteropelvic junction obstruction; however, their prevalence and morphological characteristics in adults without urinary tract obstruction remain incompletely characterized.
AIM: To determine the prevalence, vascular composition, morphological patterns, and spatial relationship of renal vessels crossing the ureteropelvic junction (UPJ) or proximal ureter using contrast-enhanced computed tomography (CT).
METHODS: A retrospective review of 197 adult patients (394 kidneys) with normal urological anatomy who underwent contrast-enhanced abdominal CT was conducted. Multiplanar and three-dimensional reconstructions were evaluated to document crossing vessel prevalence, etiology (arterial, venous, or combined), specific anatomical variations (early bifurcations or accessory vessels), spatial orientation (anterior/posterior), and exact intersection distance to the ureteropelvic.
RESULTS: Crossing vessels were identified in 56 of 394 renal units (14.2%), affecting 43 of 197 patients (21.8%), exhibiting a significant male predominance (69.6%, P = 0.007). Presentations were unilateral in 69.8% and bilateral in 30.2% of cases. Arterial anomalies predominated (64.3%), mostly due to early main renal artery bifurcations, while combined arterio-venous crossings occurred in 25% of cases. The spatial orientation was overwhelmingly anterior (98.2%). Direct UPJ intersection (0 mm) was observed in 37.5% of cases, whereas distal ureteral intersections occurred at a mean distance of 16.2 ± 4.5 mm from the junction.
CONCLUSION: Renal vessels crossing the UPJ or proximal ureter are not uncommon incidental anatomical findings on contrast-enhanced CT in adults without obstruction. Their baseline prevalence in an unobstructed cohort highlights that crossing vessels can exist without concurrent obstruction. Contrast-enhanced CT provides detailed anatomical mapping of the vascular course, which may support preoperative planning and help mitigate the risk of inadvertent vascular injury when surgical intervention is indicated. Nevertheless, functional assessment remains necessary when clinically significant obstruction is suspected.
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BibTeX
@article{paschopoulos2026aberrant,
title = {{Aberrant renal vessels crossing the ureter and the ureteropelvic junction: A retrospective computed tomography-based analysis of non-obstructed population}},
author = {Ioannis Paschopoulos and George Triantafyllou and Daniel Gondorf and Nikolaos-Achilleas Arkoudis and Georgios Velonakis and Chrysovalantis Mariorakis and Christos Lyrtzis and Kostis Gyftopoulos and Maria Piagkou},
journal = {World journal of radiology},
year = {2026},
month = oct,
doi = {10.4329/wjr.127348},
url = {https://europepmc.org/article/PMC/PMC13720562},
note = {CC BY-NC},
}
RIS
TY - JOUR
TI - Aberrant renal vessels crossing the ureter and the ureteropelvic junction: A retrospective computed tomography-based analysis of non-obstructed population
AU - Ioannis Paschopoulos
AU - George Triantafyllou
AU - Daniel Gondorf
AU - Nikolaos-Achilleas Arkoudis
AU - Georgios Velonakis
AU - Chrysovalantis Mariorakis
AU - Christos Lyrtzis
AU - Kostis Gyftopoulos
AU - Maria Piagkou
PY - 2026
DA - 2026/10/28
JO - World journal of radiology
DO - 10.4329/wjr.127348
UR - https://europepmc.org/article/PMC/PMC13720562
AB - BACKGROUND: Crossing renal vessels are recognized as potential extrinsic contributors to ureteropelvic junction obstruction; however, their prevalence and morphological characteristics in adults without urinary tract obstruction remain incompletely characterized. AIM: To determine the prevalence, vascular composition, morphological patterns, and spatial relationship of renal vessels crossing the ureteropelvic junction (UPJ) or proximal ureter using contrast-enhanced computed tomography (CT). METHODS: A retrospective review of 197 adult patients (394 kidneys) with normal urological anatomy who underwent contrast-enhanced abdominal CT was conducted. Multiplanar and three-dimensional reconstructions were evaluated to document crossing vessel prevalence, etiology (arterial, venous, or combined), specific anatomical variations (early bifurcations or accessory vessels), spatial orientation (anterior/posterior), and exact intersection distance to the ureteropelvic. RESULTS: Crossing vessels were identified in 56 of 394 renal units (14.2%), affecting 43 of 197 patients (21.8%), exhibiting a significant male predominance (69.6%, P = 0.007). Presentations were unilateral in 69.8% and bilateral in 30.2% of cases. Arterial anomalies predominated (64.3%), mostly due to early main renal artery bifurcations, while combined arterio-venous crossings occurred in 25% of cases. The spatial orientation was overwhelmingly anterior (98.2%). Direct UPJ intersection (0 mm) was observed in 37.5% of cases, whereas distal ureteral intersections occurred at a mean distance of 16.2 ± 4.5 mm from the junction. CONCLUSION: Renal vessels crossing the UPJ or proximal ureter are not uncommon incidental anatomical findings on contrast-enhanced CT in adults without obstruction. Their baseline prevalence in an unobstructed cohort highlights that crossing vessels can exist without concurrent obstruction. Contrast-enhanced CT provides detailed anatomical mapping of the vascular course, which may support preoperative planning and help mitigate the risk of inadvertent vascular injury when surgical intervention is indicated. Nevertheless, functional assessment remains necessary when clinically significant obstruction is suspected.
SN - 1949-8470
ER -