Sorin Dumitru Ioanoviciu’s scientific contributions

The liver segmentation is mainly determined by the intraparenchymatous distribution of the vascular and ductal hepatic elements; from this, the hepatic portal vein (HPV), is the most important afferent element. The lateral branches (LBrs) are serving left lateral division (LLD) of the liver and present a moderate morphological variability. On a total of 160 pieces of liver corrosion casts, one examined the intraparenchymal distribution of portal LBrs and the segmentation of LLD. Regarding the intraparenchymal distribution of the portal branches in the LLD of the liver, we showed two distinct morphological types: Type I (89.375% of cases) in which from the ombilical part of the left branch arise two LBrs; Type II (10.25% of cases) in which from the ombilical part of the left branch arise three LBrs. Knowledge of these morphological types of portal LBrs is important for clinical and surgical practice.

Domestic pigs were frequently used in training centers for residents and students in medicine for the stenting procedures at the level of renal arteries. On 12 domestic pigs (all male) with an average weight of 34 kg (30.0-39.9 kg), were analysed the morphological parameters of femoro-iliaco-aorto-renal arterial system. An analysis of the pelvic segment length (I-II-III) and abdominal (IV), shows almost perfect equality of the lengths of the two segments on the right (76.26 ± 5.30 mm / 76.21 ± 4.51 mm) and a mean difference of 1.25 mm in favour of segment IV (abdominal) (75.53 ± 5.10 mm / 76.78 ± 4.44 mm), a difference that correlate with left renal artery cranial origin. Pelvic diameter portions of femoro-iliac arterial axis increase linear in average by 10% per segment (from 3.99 ± 0.40 mm ± 4.89 in segment I at 4.89±0.33 mm in segment III). Increasing the diameter from the segment III to segment IV is approximately of 30%. The diameter of the proximal part of renal artery (3.46 ± 0.36 mm) on the studied material is smaller than the diameter of the proximal part of the external femoral artery (segment I) (3.99 ± 0.40 mm), making it easy retrograde catheterisation of femoro-iliac-aorto-renal arterial axis. Knowledge of the morphological parameters of femoro-iliaco-aortic arterial axis and their evolution in correlation with the weight of laboratory animals-domestic pigsfavours the achievement in good conditions to arterial catheterization for proximal renal artery stenting.

In accordance with Terminologia Anatomica, the renal artery gives rise of two branches: anterior branch and posterior branch. Anterior branch gives rise to four segmental arteries: superior, anterior-superior, anterior-inferior and inferior; posterior branch continues with posterior segmental artery. On a total of 150 renal corrosion casts was examined the artery of inferior segment. Three morphological types have been highlighted: Type I, in which the inferior segmental artery originating directly in the trunk of the renal artery (8.0% of cases); Type II, in which the inferior segmental artery arises from the anterior branch of the renal artery (87.33% of cases); Type III, in which the inferior segmental artery arises from the posterior branch of the renal artery (4.67% of cases). In 33.33% of cases the inferior segmental artery arises independently from the trunk or renal artery branches (anterior or posterior). In 66.67% of cases, the inferior segmental artery realizes a common trunk with one or two other segmental arteries (in type II). Knowledge of these aspects is important both to investigate morphological imaging and preforming partial resection of the renal parenchyma.

Renal parenchyma is served by a complex vascular-ductal system formed by renal artery (RA), renal vein (RV) and the pyelocaliceal system (PCS) continued by ureter. In the training of medical students and residents, the study of the interrelations of the elements of intraparenchymatous branches of the RA, RV tributaries, and PCS, as well as the analysis of renal corrosion casts is superior because it allows simultaneous analysis of the three vascular-ductal systems of the kidney. The present study examines the most favourable order of plastic mass injection for obtain good quality renal corrosion casts. There were used 36 kidneys from 18 domestic pigs, divided into three groups, to whom the vascularductal elements were injected with plastic (Technovit 7143), with different order of injection: the first group - with injection in order: PCS, RV and RA; the second group - with injection in order: PCS, RA and RV; the third group - with injection in order: RA, RV and PCS. Most affected by vascular compression were the renal vein and its intraparenchymatous tributaries. The most favourable order of plastic mass injection for obtain good quality renal corrosion casts by ex-situ injection is: RA, RV and PCS.

The liver segmentation is determined by the distribution of the vascular and ductal hepatic elements; from this, the hepatic portal vein (HPV), the central element of liver afferent pedicle, is the most important. The posterior branch (PB) is serving right lateral division (RLD) of the liver and presents the lowest morphological variability. On a total of 125 pieces of liver corrosion casts, one examined the intraparenchymal distribution of portal PB and the segmentation of RLD. Regarding the intraparenchymal distribution of the branches in the RLD of the liver, we showed four distinct morphological types: Type I (77.6% of cases) in which the PB bifurcate symmetrically in branch of segments VI and branch of segment VII; Type II (8.8% of cases) in which the PB bifurcate in branch of segment VII and an inferior branch, that bifurcate branch of segment VI and branch of segment VIA; Type III 12.8% of cases) in which the PB bifurcate in branch of segment VI and a superior branch, that bifurcate in branch of segment VII and branch of segment VIIA; Type IV (0.8% of cases) in which the PB trifurcate in branch of segment VI, branch of posterior intermediate segments, and branch of segment VII. Knowledge of these morphological types of portal PB is important for clinical and surgical practice.