Anat Cell Biol.  2022 Mar;55(1):28-39. 10.5115/acb.21.211.

Prevalence and clinical relevance of the anatomical variations of suprarenal arteries: a review

• Priya A
• Narayan RK
• Ghosh SK

• KMID: 2527666
• DOI: http://doi.org/10.5115/acb.21.211

Abstract

The suprarenal arteries are arising from three sources: superior suprarenal artery, middle suprarenal artery, and inferior suprarenal artery. Variations in the arterial supply of the suprarenal glands in respect to origin and number are quite common and very frequently reported. The most common variation noted is in the inferior suprarenal artery followed by the middle suprarenal artery and the least common variations were observed in the superior suprarenal artery. Arteriogram of the inferior suprarenal artery is crucial in suprarenal tumour diagnosis but variation in the branching pattern and multiplicity of these arteries can cause hindrance in arteriography. The absence of middle suprarenal artery was seen to be associated with increased number of the inferior suprarenal artery. Variation in the multiplicity of arteries was observed more frequently in the inferior suprarenal artery and middle suprarenal artery which was more on the right side in most of the studies. Also, the variation in suprarenal arteries was often correlated to variations in inferior phrenic and gonadal arteries. The variations were observed to be more common on the left side therefore right adrenalectomy should be preferred over the left one. The loop formed by the inferior suprarenal artery around the right renal vein can cause venous obstruction. These variations of suprarenal vasculature are explained on the developmental basis, and prior knowledge of such variants is crucial for nephrologists to ensure minimum blood loss while performing laparoscopic adrenalectomy especially for large adrenal tumours and pheochromocytoma where the duration of surgery exceeds the usual.

Keyword

Angiography; Inferior suprarenal arteries; Middle suprarenal arteries; Superior suprarenal arteries; Suprarenal gland

Figure

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  Fig. 1 Schematic diagram of arterial supply of suprarenal gland. (A) Shows normal arterial supply of the suprarenal gland. (B) Shows the most common variant origins of superior, middle, and inferior suprarenal arteries being reported. IVC, inferior vena cava; IPA, inferior phrenic artery; SSA, superior suprarenal artery; MSA, middle suprarenal artery; ISA, inferior suprarenal artery; SMA, superior mesenteric artery; CT, coeliac trunk; SA, splenic artery; ARA, accessory renal artery; SSAAA, superior suprarenal artery originating from the abdominal aorta; MSACT, middle suprarenal artery originating from the coeliac trunk; ISAAA, inferior suprarenal artery originating from the abdominal aorta; SSACT, superior suprarenal artery originating from the coeliac trunk; MSASMA, middle suprarenal artery originating from superior mesenteric artery; ISAGA, inferior suprarenal artery originating from gonadal artery.

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  Fig. 2 A chronological illustration of hitherto most significant findings in the research history of arterial variations of suprarenal arteries. SSA, superior suprarenal artery; AA, abdominal aorta; RA, renal artery; MSA, middle suprarenal artery; ISA, inferior suprarenal artery.

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