Variant renal arteries

Case contributed by Dr Bruno Di Muzio


Potential living renal donor, imaging workup.

Patient Data

Age: 50 years

CT Renal

Renal length: Right - 10.0 cm Left - 10.0 cm

Renal arteries (number):

  • Right 3 - one small upper pole capsular artery and 2 other similar sized arteries
  • Left 3 - 3 arteries of similar size.

Renal Veins (number):

  • Right 2
  • Left 1

Retroaortic or anomalous tributaries: None

Ureters (number, anomalies): Right & left - single and conventional

Case Discussion

This case illustrates renal artery anatomical variants identified on the workup for a potential donor. The right kidney has, besides the main renal artery, a lower polar artery and an upper capsular accessory artery. The left kidney has three equal-sized renal arteries (upper, middle, and lower). These findings are relevant, as the surgeons, if considering to transplant one of these kidneys, will probably need to create separate anastomotic sites in the recipient iliac artery, thus increasing the risk of potential complications.

Following publications in this field 1, in cases of multiple renal arteries, at our institution we use the term "renal arteries" when they are of the same size and "renal and accessory arteries" when there is one dominant and other smaller artery/arteries.

It is important to bear in mind that accessory renal arteries may also rarely arise from other arteries rather the aorta, such as the

  • superior or inferior mesenteric artery
  • celiac artery
  • middle colic artery
  • lumbar arteries
  • gonadal arteries
  • iliac arteries
  • middle sacral arteries
  • even from the contralateral renal artery 1
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Case information

rID: 53683
Published: 4th Jun 2017
Last edited: 5th Jun 2017
Inclusion in quiz mode: Excluded

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