Clinically important left superior polar artery giving rise to a left inferior suprarenal artery and an aberrant left inferior polar artery: a case report
Artéria polar superior esquerda de importância clínica dando origem à artéria suprarrenal inferior esquerda e artéria polar inferior esquerda aberrante: relato de caso
Naveen Kumar; Ashwini Aithal Padur; Mohandas Rao Kappettu Gadahad; Swamy Ravindra Shanthakumar
Abstract
The renal arteries arise from the lateral side of the abdominal aorta at the L2 vertebral level, just below the origin of the superior mesenteric artery. Multiple aberrant renal arteries can pose difficulties in renal transplantation, interventional radiological and urological procedures, renal artery embolization, angioplasty, or vascular reconstruction for congenital and acquired lesions. We present a case of a left kidney supplied by the left renal artery along with superior and inferior polar arteries, arising from the aorta and inferior mesenteric artery respectively. The inferior mesenteric artery was crossed by the left ureter and inferior mesenteric vein. The superior polar artery gave rise to an inferior suprarenal artery making the variation important for clinicians and surgeons.
Keywords
Resumo
As artérias renais originam-se do lado lateral da aorta abdominal, no nível da vértebra L2, logo abaixo da origem da artéria mesentérica superior. A presença de múltiplas artérias renais aberrantes pode representar dificuldades para transplante renal, procedimentos radiológicos e urológicos intervencionistas, embolização da artéria renal, angioplastia e reconstrução vascular para lesões congênitas e adquiridas. Apresentamos um caso de rim esquerdo vascularizado pela artéria renal esquerda e pelas artérias polares superior e inferior, as quais se originavam da aorta e da artéria mesentérica inferior, respectivamente. A artéria mesentérica inferior era cruzada pelo ureter esquerdo e pela veia mesentérica inferior. A artéria polar superior dava origem à artéria suprarrenal inferior, o que torna essa variação importante para clínicos e cirurgiões.
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Referências
1. Palmieri BJ, Petroianu A, Silva LC, Andrade LM, Alberti LR. Study of the arterial pattern of 200 renal pedicles through angiotomography. Rev Col Bras Cir. 2011;38(2):116-21. http://dx.doi.org/10.1590/ S0100-69912011000200009. PMid:21710050.
2. Felix W. Mesonephric arteries (aa. mesonephricae). In: Kiebel F, Mall FP, editors. Manual of human embryology. 2nd ed. Philadelphia: Lippincott; 1912. p. 820-5.
3. Kumar N, Ashwini AP, Swamy RS, et al. Unilateral double right renal arteries - a case report. Int J Health Sci Res. 2014;4(5):335-8.
4. Sampaio FJ, Passos MA. Renal arteries: anatomic study for surgical and radiological practice. Surg Radiol Anat. 1992;14(2):113-7. http://dx.doi.org/10.1007/BF01794885. PMid:1641734.
5. 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):24-8. PMid:21604249.
6. Chauhan K, Patel SJ, Patel RK, Mehta CD, Desai M. Variant origin of renal arteries and its clinical implication. CIBTech J Surg. 2013;2(2):7-12.
7. Ankolekar V, Sengupta R. Renal artery variations: a cadaveric study with clinical relevance. Int J Curr Res Rev. 2013;5(5):154-61.
8. Khamanarong K, Prachaney P, Utraravichien A, Tong-Un T, Sripaoraya K. Anatomy of renal arterial supply. Clin Anat. 2004;17(4):334-6. http://dx.doi.org/10.1002/ca.10236. PMid:15108340. Kumar et al. J Vasc Bras. 2023;22:e20230012. https://doi.org/10.1590/1677-5449.202300122 4/4
9. Shakeri AB, Tubbs RS, Shoja MM, et al. Bipolar supernumerary renal artery. Surg Radiol Anat. 2007;29(1):89-92. http://dx.doi. org/10.1007/s00276-006-0158-0. PMid:17061029.
10. Patil SJ, Mishra S. Inferior renal polar artery and its surgical importance. OA Anatomy. 2013;1(2):17. http://dx.doi. org/10.13172/2052-7829-1-2-750.
11. Ravery V, Cussenot O, Desgrandchamps F, et al. Variations in arterial blood supply and the risk of hemorrhage during percutaneous treatment of lesions of the pelviureteral junction obstruction: report of a case of testicular artery arising from an inferior polar renal artery. Surg Radiol Anat. 1993;15(4):355-9. http://dx.doi. org/10.1007/BF01627892. PMid:8128346.
12. Mishra A. Crossing renal vessel causing ureteropelvic junction obstruction. Saudi Med J. 2006;27(9):1415-7. PMid:16951786.
13. Reddy MV, Ahmed MM, Kumar PP, Raghuramaiah G. A study on vasculature of the suprarenal glands. Int J Anat Res. 2014;2(1):195-201.
Submetido em:
31/01/2023
Aceito em:
06/04/2023
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