Vol 78, No 1 (2019)
Case report
Published online: 2018-05-17
Four left renal arteries — a rare variant of kidney arterial supply
Abstract
We describe the arterial supply of a human kidney harvested post-mortem from a 75-year-old female volunteer body donor. The kidney was analysed with con- trast-enhanced computed tomography (CT), and corrosion casting was used to reveal the kidney’s angio-architecture. In the left kidney, we observed four renal arteries, each originating directly from the abdominal aorta. Three renal arteries, including the main renal artery, coursed through the renal hilum, and the fourth renal artery reached the lower kidney pole. The supply areas of each of the four renal arteries were analysed with a three-dimensional reconstruction of CT images and with corrosion casting. There were no clear boundaries between the areas supplied by the four renal arteries because their branches overlapped in most kidney segments.
Keywords: renal arteryaccessorysupernumeraryanatomical variationcorrosion castingcomputed tomography
References
- Bachul PJ, Osuch C, Chang ES, et al. Crossing anatomic barriers-transplantation of a kidney with 5 arteries, duplication of the pyelocalyceal system, and double ureter. Cell Transplant. 2017; 26(10): 1669–1672.
- Bordei P, Sapte E, Iliescu D. Double renal arteries originating from the aorta. Surg Radiol Anat. 2004; 26(6): 474–479.
- Budhiraja V, Rastogi R, Asthana AK. Variant origin of superior polar artery and unusual hilar branching pattern of renal artery with clinical correlation. Folia Morphol. 2011; 70(1): 24–28.
- Budhiraja V, Rastogi R, ain V, et al. Anatomical variations of renal artery and its clinical correlations: a cadaveric study from central India. J Morphol Sci. 2013; 30(4): 228–233.
- Dogra A, Chauhan RS, Sharma S, et al. Variations of renal arteries on 64 slice Multidetector Computed Tomography. J Anat Soc India. 2017; 66(1): 20–25.
- Graves FT. The aberrant renal artery. J Anat. 1956; 90(4): 553–558.
- Gulas E, Wysiadecki G, Szymański J, et al. Morphological and clinical aspects of the occurrence of accessory (multiple) renal arteries. Arch Med Sci. 2018; 14(2): 442–453.
- Hapugoda S, Knipe H. Accessory renal artery. Radiopedia. https://radiopaedia.org/articles/accessory-renal-artery (January 3rd 2018).
- Hassan SS, El-Shaarawy EA, Johnson JC, et al. Incidence of variations in human cadaveric renal vessels. Folia Morphol. 2017; 76(3): 394–407.
- Jeon YJ, Lee JN, Yoon SP. Bilateral asymmetrical multiple renal arteries associated with the left testicular artery. Folia Morphol. 2014; 73(4): 510–513.
- Kadir S. Kidneys. In: Kadir S (ed.), Atlas of normal and variant angiographic anatomy. Philadelphia: W.B. Saunders Company. 1991: 387–429.
- Kinnunen J, Tötterman S, Tervahartiala P. Ten renal arteries. Eur J Radiol. 1985; 5(4): 300–301.
- Koplay M, Onbas O, Alper F, et al. Multiple renal arteries: variations demonstrated by multidetector computed tomography angiography. Med Princ Pract. 2010; 19(5): 412–414.
- Merklin RJ, Michels NA. The variant renal and suprarenal blood supply with data on the inferior phrenic, ureteral and gonadal arteries: a statistical analysis based on 185 dissections and review of the literature. J Int Coll Surg. 1958; 29(1 Pt 1): 41–76.
- Miclaus GD, Matusz P. Bilateral quadruple renal arteries. Clin Anat. 2012; 25(8): 973–976.
- Mishra A, Sharma PK, Manik P, et al. Bilateral multiple renal arteries: A case report. OA Anatomy. 2014; 2(3): 22.
- Orlando G, Gravante G, D'Angelo M, et al. A renal graft with six arteries and double pelvis. Transpl Int. 2008; 21(6): 609–611.
- Ozkan U, Oğuzkurt L, Tercan F, et al. Renal artery origins and variations: angiographic evaluation of 855 consecutive patients. Diagn Interv Radiol. 2006; 12(4): 183–186.
- Patil UD, Ragavan A, Nadaraj T, et al. Helical CT angiography in evaluation of live kidney donors. Nephrol Dial Transplant. 2001; 16(9): 1900–1904.
- Pollak R, Prusak BF, Mozes MF. Anatomic abnormalities of cadaver kidneys procured for purposes of transplantation. Am Surg. 1986; 52(5): 233–235.
- Rossi UG, Romano M, Ferro C. Seven renal arteries. Clin Anat. 2006; 19(7): 632–633.
- Saldarriaga B, Pérez AF, Ballesteros LE. A direct anatomical study of additional renal arteries in a Colombian mestizo population. Folia Morphol. 2008; 67(2): 129–134.
- Satyapal KS, Haffejee AA, Singh B, et al. Additional renal arteries: incidence and morphometry. Surg Radiol Anat. 2001; 23(1): 33–38.
- Soares T, Ferraz J, Dartibale C, et al. Variations in human renal arteries. Acta Scientiarum Biological Sciences. 2013; 35(2): 277–282.
- Sośnik H, Sośnik K. Investigations on renal vascularisation pathology in the Polish population. 1. Incidence of multiple kidney arteries. Folia Morphol. 2017; 76(2): 226–231.
- Stanca VD, Precup D, Popescu A, et al. Anatomic variants of origin, number and course of the renal arteries. an anatomical study. Medical Connections. 2013; 4(32): 19–23.
- Staśkiewicz G, Jajko K, Torres K, et al. Supernumerary renal vessels: analysis of frequency and configuration in 996 computed tomography studies. Folia Morphol. 2016; 75(2): 245–250.
- Tarzamni MK, Nezami N, Rashid RJ, et al. Anatomical differences in the right and left renal arterial patterns. Folia Morphol. 2008; 67(2): 104–110.
- Türkvatan A, Ozdemir M, Cumhur T, et al. Multidetector CT angiography of renal vasculature: normal anatomy and variants. Eur Radiol. 2009; 19(1): 236–244.
- Vilhova I, Kryvko YY, Maciejewski R. The radioanatomical research of plural renal arteries. Folia Morphol. 2001; 60(4): 337–341.
- Weld KJ, Bhayani SB, Belani J, et al. Extrarenal vascular anatomy of kidney: assessment of variations and their relevance to partial nephrectomy. Urology. 2005; 66(5): 985–989.
- Wozniak WT. Origin of the renal arteries from sides of aorta. Folia Morphol. 2000; 58(4): 259–261.
