Anatomy - Aortobifemoral bypass for peripheral arterial disease Fontaine stage IIb–III

Main branches

Course

Branches/rami and distribution

Inferior phrenic artery

• Travels craniad along the underside of the diaphragm towards the diaphragmatic dome
• Network-like division into several terminal branches

Superior suprarenal artery: Suprarenal gland

Terminal branches: Underside of the diaphragm

Middle suprarenal artery

• Travels laterad to the suprarenal glands

Terminal branches: Suprarenal glands

Renal artery

• Arises at the level of L1–2
• Right renal artery: Travels posterior to the vena cava and pancreatic head to the right kidney
• Left renal artery: Travels posterior to the body of the pancreas to the left kidney

Inferior suprarenal artery: Suprarenal gland

Ovarian artery 

Testicular artery

• Arises from the anterior wall of the aorta inferior to the renal arteries / L2
• Travels across the psoas muscle, ureter, and external iliac artery to the suspensory ligament of ovary / deep inguinal ring and testis

Ovarian arteries: Ovaries, parts of the uterine tubes

Testicular arteries: Testes, epididymides

Lumbar arteries (4 bilat.)

• Travels lateroposteriad to the psoas muscle across L1–4
• Anastomose with the arteries of the anterior abdominal wall (superior and inferior epigastric arteries; liliolumbar artery; deep circumflex iliac artery)

Spinal rami: Spinal canal

Terminal branches: Abdominal wall, back muscles