Anatomy - Percutaneous transluminal angioplasty with stent implantation for bilateral renal artery stenosis

Origin

• from the thoracic aorta after its passage through the aortic hiatus of the diaphragm at the level of the 12th thoracic vertebra (T12)

Course

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

Branches from cranial to caudal

• Inferior phrenic arteries
• Celiac trunk
• Middle suprarenal artery, right and left
• Superior mesenteric artery
• Right and left renal artery
• Right and left ovarian / testicular artery
• Lumbar arteries
• Inferior mesenteric artery
• Median sacral artery

Arterial blood supply for

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

Arterial supply to the kidney is via the renal arteries, which originate directly from the aorta. Venous return is via the homonymous renal veins, which terminate in the inferior vena cava.

After arising from the abdominal aorta, the right renal artery runs posterior to the inferior vena cava, while the left renal artery travels directly to the renal hilum. The reverse is true for the veins: the right renal vein travels directly to the inferior vena cava, whereas the left renal vein runs anterior to the aorta.

The renal artery divides shortly before the renal hilum into its principal branches (rami principales). Around 18% of the population have more than one renal artery, and 2–3% have even more than three renal arteries.