Accessory renal artery

Last revised by Craig Hacking on 22 Feb 2024

Accessory renal arteries are a common variant of the renal arteries. They are present in ~25% (range 20-30%) of the population and bilateral in ~10% 1. Accurate identification is of utmost importance for surgical planning prior to live donor transplantation 2,3 and renal artery embolization for various reasons 4,5.

The term extra renal artery may be used 6, with a subclassification into:

  • aberrant renal artery: supplying the superior and/or inferior pole of the kidney
  • accessory renal artery: supplying the renal hilum

Accessory renal arteries occur bilaterally in 10-15% of cases:

  • single renal artery arising from the abdominal aorta: 70%
  • double renal arteries: ~20% (range 14-23%)
  • triple renal arteries: ~2.5% (range 1-4%)
  • quadruple renal arteries: <1%

Most commonly accessory renal arteries arise from the abdominal aorta and supply the inferior pole of the kidney, although rarely they can arise from:

History and etymology

The first recorded case of multiple renal arteries was described by Eustachius in 1552 7.

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Cases and figures

  • Figure 1: illustration
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  • Case 1: MRA
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  • Case 2: causing PUJ obstruciton
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  • Case 3: bilateral accessory
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  • Case 4: with aortic aneurysm
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  • Case 5
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  • Case 6: bilateral
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  • Case 7: bilateral variants
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  • Case 8: triple right renal arteries
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  • Case 9: bilateral
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  • Case 10: precaval accessory right renal artery
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  • Case 11: aberrant extra renal artery and vein arising from common iliac vessels
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