3D Volume rendered maximum intensity projection (MIP) CT angio images in a 29 year old male donor scheduled for donor nephrectomy showing Accessory renal artery on the left side with prehilar branching on right side.
- Multiple renal arteries are unilateral in approximately 30% of patients and bilateral in approximately 10%.
- Accessory arteries usually arise from the aorta or iliac arteries anywhere from the level of T11 to the level of L4.
- In rare cases, they can arise from the lower thoracic aorta or from lumbar or mesenteric arteries.
- Usually, the accessory artery courses into the renal hilum to perfuse the upper or lower renal poles.
- Prehilar arterial branching is another common variant that must be checked in patients being evaluated for donor nephrectomy.