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Case Reports
. 2024 Dec 19;11(2):101713.
doi: 10.1016/j.jvscit.2024.101713. eCollection 2025 Apr.

Aberrant right renal perfusion from right internal mammary artery

Avkash J Patel  1 , Woosup Michael Park  1 , Jirat Chenbhanich  2 , Heather L Gornik  3 , Jae S Cho  1
Affiliations
Case Reports

Aberrant right renal perfusion from right internal mammary artery

Avkash J Patel et al. J Vasc Surg Cases Innov Tech. .

Abstract

Renal artery (RA) anomaly is common and may have significant clinical implications. We present a case of a 29-year-old man in whom the upper two-thirds of the right kidney were supplied by the right internal mammary artery and collateral network. Additionally, the superior left RA had proximal stenosis with a distal aneurysm. Renin sampling confirmed renovascular hypertension. He successfully underwent aorta-to-superior right RA bypass and primary repair of superior left RA aneurysm. This case adds to existing knowledge of RA anomalies, and underscores the importance of comprehensive evaluations for alternate renal blood supply for effective surgical management of renovascular hypertension.

Keywords: Aberrant renal artery; Alport syndrome; Fibromuscular dysplasia; Renal artery aneurysm; Renovascular hypertension.

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Conflict of interest statement

None.

Figures

Fig 1
Fig 1
Three-dimensional reconstruction of computed tomography angiography demonstrating right internal mammary artery (RIMA) collateral supplying the right kidney via the superior right renal artery (RRA) as well as an aneurysm of the superior left RA (LRA).
Fig 2
Fig 2
(A) Aortogram demonstrating asymmetric filling of bilateral kidneys. (B) Angiogram demonstrating filling of the upper two-thirds of the right renal parenchyma via a collateral network originating from the right internal mammary artery (RIMA) and right inferior phrenic artery (IPA). (C) Angiogram demonstrating superior left RA (LRA) aneurysm. RRA, right renal artery.
Fig 3
Fig 3
Intraoperative images demonstrating (A) occluded origin of superior right renal artery (RRA) with large right inferior phrenic artery (IPA) collateral. (B) Superior left RA (LRA) aneurysm. (C) Aorta-to-RRA bypass with 6-mm woven polyester graft and primary anastomosis of the LRA.
See this image and copyright information in PMC

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