Renal Angiography and Embolization

Abstract

In order to safely and effectively perform renal arterial interventions, a fundamental understanding of the normal and variant renal vascular anatomy is essential. The renal arteries most commonly originate from the aorta approximately 1 cm distal to the origin of the superior mesenteric artery, at the level of the lower 1st and upper 2nd lumbar vertebrae. In a majority of patients (approximately 70 %), there is a single renal artery to each kidney. The left renal artery is shorter than the right, given its proximity to the aorta. The kidney is composed of five segments: apical, upper, middle, lower, and posterior. The posterior division artery is usually the first branch of the main renal artery and supplies the posterior segment of the kidney. The anterior division splits into three terminal segmental arteries: superior to the upper segment, middle or medial to the middle segment, and inferior to the lower segment. The vascular supply to the apical segment is usually provided by the anterior division artery but in approximately 10 % of cases may have supply from the posterior division. There are also smaller branches supplying the renal pelvis and proximal ureter which can originate from the main renal artery and its branches.