CTA anatomical studyBratislava Medical Journal2025Open Access

Anatomical Study and Classification of the Precaval Right Renal Arteries

A 200-case angioCT study that quantifies precaval right renal arteries, proposes a topographic classification, and highlights surgically important rare configurations.

Nawwaf Sebastian Damen · Adelina Maria Jianu · Mugurel Constantin Rusu
Central finding

Precaval right renal arteries are not rare and require topographic, not merely numerical, description.

Among 200 archived angioCT studies, 24 patients had 25 precaval RRAs. The study proposed a surgical classification based on the vessel’s relationship to the renal vein and renal entry site.

12%patients with a precaval RRA
01 · Cohort

Two hundred CT angiograms

The study examined 105 males and 95 females and defined four broad topographic types, with five specific precaval subtypes.

200

Cases

Archived angioCT datasets.

24

Patients

Had at least one precaval RRA.

25

Precaval arteries

One patient had a double precaval RRA.

L2–L5

Origin levels

Range in 23 of the 24 precaval cases.

02 · Precaval subtypes

Click the subtype

The classification captures where a precaval artery enters the kidney and how it relates to the right renal vein.

Type 2a · hilar precaval artery — 9 cases

The precaval RRA entered the renal hilum as a hilar artery.

03 · Distribution

Subtype counts

The most frequent precaval subtype was 2a.

2a · hilar
9
2b · inferior polar
3
2c · inferior hilar angle
6
3a · anterior to RRV
2
3b · posterior to RRV
3
Novel/rare observations: one precaval RRA arose from the right common iliac artery; a thoracic RRA coexisted with a precaval RRA; and a direct precaval-to-retrocaval RRA anastomosis represented a previously undescribed macroscopic collateral pathway.