Accessory Renal Arteries Involved in Atherosclerotic Occlusive Disease at the Aortic Bifurcation

Abstract Accessory renal arteries are embryonic remnants found in over one-third of patients and occurring bilaterally in 10 percent of the population. Very few reports have documented such vessels arising near or at the level of the aortic bifurcation. Furthermore, the presence of accessory renal arteries has yet to be described in the context of atherosclerotic disease. Here, we present a unique case of large bilateral accessory renal arteries originating above the aortic bifurcation, concurrent with symptomatic aortoiliac atherosclerotic disease. We highlight the embryological and clinical significance of these vessels as well as discuss their potential role in accelerating atherosclerotic disease processes.