Bilateral supernumerary renal arteries with variant ureteric relation and their embryological and clinical significance

Variations in the renal vasculature always deserve a special attention owing to its higher prevalence and wider range. A thorough knowledge of the normal morphology and the variations in the origin, course, branches and distribution of the renal vasculature are essential for the successful outcome of the surgical interventions in this region without dreadful complications. During routine dissection for the undergraduate medical students following the standard procedures, dissection of the retroperitoneal region in a male cadaver, revealed bilateral variations in the number, origin, course and branches of the renal arteries.The renal arteries with its branches were dissected out meticulously and the variations encountered were documented. Bilateral supernumerary renal arteries with extra-hilar and pre-hilar branches were observed. In addition, it was found that the supernumerary inferior pre- caval right renal artery had a variant course in relation to ureter before entering the hilum of the right kidney. The variant renal arteries documented in the present study with their embryological correlation is clinically important in the urological management, especially during the laparoscopic donor nephrectomy, where the field of vision is limited and also in the endovascular renal artery denervation procedure, which is an useful adjuvant for the patients having drug-resistant primary hypertension.