A rare bilateral renal arterial configuration featuring a right-sided crossed trajectory and left-sided type IIa branching: morphometric and embryological insights from cadaveric dissection.

PURPOSE: This study aimed to report and characterize bilateral renal artery (RA) variations observed during cadaveric dissection and to evaluate these findings in the context of embryological development and morphometric analysis.

CASE PRESENTATION: During routine anatomical dissection of an 87-year-old Caucasian male cadaver, bilateral variations in the renal arteries were identified. On the right side, two renal arteries (RRA1 and RRA2) were observed, each giving rise to presegmental and segmental branches. Notably, the RRA1 also gave rise to the right inferior suprarenal artery. This arterial configuration was consistent with the crossed different trajectory pattern, corresponding to Type C. On the left side, a single left renal artery (LRA) bifurcated into one presegmental and one segmental branch, consistent with type IIa. Morphometric analysis performed using ImageJ software revealed that the RRA1 measured 57.75 mm in length, with a diameter of 4.59 mm at its branching point. The RRA2 was 55.1 mm long, with a midpoint diameter of 4.29 mm. The LRA measured 29.25 mm in length, with diameters of 8.71 mm at its origin and 7.23 mm at its mid-length.

CONCLUSIONS

This case reveals an uncommon combination of bilateral renal artery variations, emphasizing the complexity and variability of the renal vasculature. The right-sided crossed arterial configuration and left-sided perihilar branching reflect embryologically persistent mesonephric arteries, particularly from the caudal group. These findings emphasize the importance of preoperative vascular mapping and individualized anatomical assessment to prevent complications during retroperitoneal surgery, renal transplantation, and interventional radiological procedures. Understanding such variations in the embryological and morphometric contexts is essential for improving patient safety and procedural accuracy.