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

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.

A rare case of multiple visceral vascular variations around the kidneys: morphological and clinical aspects

“…15 Concomitant presence of an aberrant gonadal artery with variant suprarenal arteries and increased number of inferior suprarenal arteries, like in the present case, has been described in previous reports. 16 Kayalvizhi et al 17 in 2017 reported in their review that the incidence of 'arched testicular artery' or the 'arched gonadal artery of Luschka' ranges from 1.7% to 20.3%. The arched testicular artery observed here can be classified as type-III variety of the testicular artery, as per the Notkovich classification system.…”

“… 15 Concomitant presence of an aberrant gonadal artery with variant suprarenal arteries and increased number of inferior suprarenal arteries, like in the present case, has been described in previous reports. 16 …”

Anatomical variations of the canine adrenal vessels

“…Although it may be challenging to depict the adrenal blood vessels in ultrasmall dogs (less than 3 kg), further studies are needed because the number of cases of ultrasmall dogs is small in this study. In humans, adrenal arteries have also been reported to branch from gonadal, splenic and intercostal arteries (Priya et al, 2022 .). However, no branching from these arteries was reported in dogs before.…”

“…The blood supply of the adrenal glands comprises numerous branches from three types of arteries in humans: the superior adrenal artery, the middle superior adrenal artery and the inferior superior adrenal artery. A review on variations of these three types of adrenal arteries in humans has been published (Priya et al, 2022 ). In dogs, the adrenal glands are variously but always generously vascularized by small branches from the aorta, as well as the caudal phrenic, cranial abdominal, phrenicoabdominal, cranial mesenteric, celiac, renal and lumbar arteries (Hullinger, 2013 ; Singh, 2018 ).…”