Suprarenal Arteries

10 Suprarenal Arteries

K.I. Ringe, S. Meyer

The official anatomical nomenclature cites three arteries supplying the suprarenal gland:

– The superior suprarenal artery from the inferior phrenic artery.

– The middle suprarenal artery, a direct branch of the aorta.

– The inferior suprarenal artery, a branch from the renal artery.

However, careful preparations after dye injection or corrosion cast preparations give a much more complex picture. The suprarenal arteries are always multiple, and they branch before entering the gland. They could be compared with spokes of a wheel, the suprarenal gland serving as the hub. Up to 60 arterial branches have been counted to enter the gland.¹^–⁹ The venous return, however, takes place via only one suprarenal vein; accessory veins are rarely found.

The inferior suprarenal arteries are in part derived directly from the renal arteries and in part from the renal capsule, which is supplied not only by the renal artery but also by branches from the testicular, ovarian, or lumbar arteries. Even a direct origin of the inferior suprarenal artery from the testicular and ovarian arteries has been described.¹^–³^,⁷^,⁹

10.1 Blood Supply from Three Different Origins (34%)

Fig. 10.1 Blood supply from three different origins (34%). Schematic.

10.2 Blood Supply from Two Different Origins (61%)

Fig. 10.2 From the inferior phrenic artery and the aorta (more often left than right) (26%). Schematic (a) and CT images (b,c) in a patient with a large adrenal mass on the left (*). MIP in coronal oblique (b) and axial (c) view. The suprarenal gland is supplied by branches (arrows) from the inferior phrenic artery and the aorta. 1 Left phrenic artery; 2 splenic artery.