Anatomy - Endoaneurysmorrhaphy with intraluminal straight graft placement in infrarenal abominal aortic aneurysm - Vascular Surgery

Main branches

Course

Branches and their distribution

Inferior phrenic artery

• Courses craniad on inferior aspect of diaphragm toward its dome
• Reticular division into several terminal branches

Superior suprarenal artery: adrenal gland

Terminal branches: inferior aspect of diaphragm

Middle suprarenal artery

• Courses laterad to the adrenal glands

Terminal branches: adrenal glands

Renal artery

• Arises at around the level of the first / second lumbar vertebra (L1-2)
• Right renal artery: courses posterior to inferior vena cava and head of pancreas to right kidney
• Left renal artery: courses posterior to body of pancreas to left kidney

Inferior suprarenal artery: adrenal gland

Ovarian artery, 

Testicular artery

• Arises inferior to the renal arteries /second lumbar vertebra (L2) from anterior aspect of aorta
• Crosses over psoas muscle, ureter and external iliac arteries to suspensory ligament of ovary / deep inguinal ring and testes

Ovarian artery ovary, parts of uterine tube

Testicular artery: testes, epididymides

Lumbar arteries (bilateral 4)

• Run laterad posterior to psoas muscle over 1st to 4th lumbar vertebra (L1–4)
• Anastomose with arteries of the anterior abdominal wall (superior and inferior epigastric arteries, iliolumbar artery, deep circumflex iliac artery)

Spinal branches: spinal canal

Terminal branches: abdominal wall, muscles of the back