Anatomical variations of polar renal arterial sources and their clinical importance

Abstract

Normally, the polar parenchymas are distinctive segments supplied by the segmental branches of the renal artery. The study, which was conducted using 20 CT angiographies and 40 kidney dissections and microdissections, revealed 14 cases of polar arteries (6 superior and 8 inferior). Their origin and importance in the vascularisation of the renal poles were analysed. The superior polar arteries originated in the abdominal part of the aorta (supernumerary arteries) in 2 cases and in the renal artery in 4 cases (polar renal arteries). One of the left superior polar renal arteries had a venous branch and a nerve plexus that together formed a vasculo‐nervous pedicle. In 2 of the 5 superior artery cases, the superior polar arteries were the single arterial source of the superior pole. In the other 3 cases, the polar arteries joined several segmental branches originating in the anterior branch of the renal artery trunk (2 cases) and in the posterior branch (1 case). The inferior polar arteries originated from the aorta in 7 cases and from the left gonadal artery (travelling anterior to the ureter) in one case. In all cases of inferior polar arteries, these were associated with inferior segmental arterial branches. Familiarity with renal artery vascularisation and its numerous variants is an important aspect involved in the preoperative evaluation of patients undergoing urological interventions.