Coexisting Thoracoabdominal Aortic Tortuosity With Multifocal Atherosclerosis and Bilateral Renal Venous Tributaries Variations: A Cadaveric Case Report.

Aortic tortuosity is a documented anatomical finding associated with alterations in vascular structure, arterial wall modifications, and age-related degenerative alterations. Variations in the anatomy of renal venous tributaries are also frequent and may have important implications for retroperitoneal surgery, transplantation, and vascular interventions. During a routine gross anatomy lab cadaveric dissection of an adult female of unknown age, diffuse thoracoabdominal aortic tortuosity, atherosclerosis, and bilateral renal venous tributary variations were identified. The aorta followed a markedly tortuous course involving both the thoracic and abdominal segments and demonstrated a tortuosity index of 1.29. Examination of the opened vessel revealed multifocal atherosclerotic changes in the thoracic and abdominal aorta. Grade III atherosclerosis, characterized by calcified plaques and focal intimal ulcerations, was observed within the aortic arch. Bilateral multiple hilar venous tributaries converged into the main renal veins, with a posteriorly positioned tributary contributing to an atypical hilar arrangement on the left side. This case documents the coexistence of diffuse thoracoabdominal aortic tortuosity, atherosclerotic disease, and variations in bilateral renal venous tributaries in a cadaver. These findings highlight the value of cadaveric dissection in identifying clinically relevant vascular anatomy and underscore the importance of recognizing complex aortic and renal venous configurations during anatomical education, radiologic interpretation, surgical planning, and endovascular procedures.