Anatomy - Aortoiliac TEA (thromboendarterectomy) in bilateral stage IIb peripheral arterial (occlusive) disease (PAD) - Vascular surgery - vascular surgery

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  • Abdominal aorta

    Abdominal aorta
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    Origin

    • It is the extension of the thoracic aorta after it passes through the aortic hiatus at the level of 12th thoracic vertebra (T12)

    Course

    • Retroperitoneal
    • Left of midline, anterior to spine
    • At the level of umbilicus/4th lumbar vertebra (L4) dividing (aortic bifurcation) into the common iliac arteries

    Cephalocaudal branches

    • Inferior phrenic arteries
    • Celiac trunk
    • Middle suprarenal artery (left and right)
    • Superior mesenteric artery
    • Renal artery (left and right)
    • LOvarian / testicular artery (left and right)
    • Lumbar arteries
    • Inferior mesenteric artery
    • Median sacral artery

    Distribution

    • Paired branches: abdominal wall, paired retroperitoneal organs, gonads
    • Unpaired branches: spleen, unpaired digestive organs

  • Paired branches of the abdominal aorta

    Main branches

    Course

    Branches and their distribution

    Inferior phrenic artery

    • Courses craniad on inferior aspect of diaphragm toward its dome
    • Reticular division into several terminal branches

    Superior suprarenal artery: adrenal gland

    Terminal branches: inferior aspect of diaphragm

    Middle suprarenal artery

    • Courses laterad to the adrenal glands

    Terminal branches: adrenal glands

    Renal artery

    • Arises at around the level of the first / second lumbar vertebra (L1-2)
    • Right renal artery: courses posterior to inferior vena cava and head of pancreas to right kidney
    • Left renal artery: courses posterior to body of pancreas to left kidney

    Inferior suprarenal artery: adrenal gland

    Ovarian artery, 

    Testicular artery

    • Arises inferior to the renal arteries /second lumbar vertebra (L2) from anterior aspect of aorta
    • Crosses over psoas muscle, ureter and external iliac arteries to suspensory ligament of ovary / deep inguinal ring and testes

    Ovarian artery ovary, parts of uterine tube

    Testicular artery: testes, epididymides

    Lumbar arteries (bilateral 4)

    • Run laterad posterior to psoas muscle over 1st to 4th lumbar vertebra (L1–4)
    • Anastomose with arteries of the anterior abdominal wall (superior and inferior epigastric arteries, iliolumbar artery, deep circumflex iliac artery)

    Spinal branches: spinal canal

    Terminal branches: abdominal wall, muscles of the back

  • Unpaired branches of the abdominal aorta

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  • Arterial pelvic blood supply

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  1. Abdominal aorta
  2. Paired branches of the abdominal aorta
  3. Unpaired branches of the abdominal aorta
  4. Arterial pelvic blood supply

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