Thoracic renal artery: a rare variant. A case study and literature review.

ABSTRACT

BACKGROUND: Variations in the course of paired renal arteries are common and are known causes of iatrogenic injury. However, a thoracic origin of the renal artery is rare and poses a greater risk for iatrogenic injury especially during thoracic endovascular or surgical interventions. PURPOSE: To describe a renal artery variant, its clinical implications in the context of procedural interventions, and to provide a literature review on renal artery variations. METHODS: An abdominal CT scan with IV contrast was obtained using a GE 64-slice helical CT scanner with subsequent sagittal, coronal, and 3-D reformations. A literature review was performed using Index Medicus. RESULTS: Right renal artery variant arising from the thoracic aorta at the lower aspect of the T10 vertebral body, coursing posteroinferiorly through the right diaphragmatic crux before reaching the right kidney hilum. CONCLUSION: A thoracic origin of the renal artery is an uncommon but important risk factor for vascular injury during endovascular and surgical interventions especially in the thorax. 3-D CT or CT angiography prior to an indicated procedure may prove useful for pre-interventional planning.