Variations in the anatomic relationship of the left renal vein to the left renal artery at the aorta

Anatomic textbook descriptions imply that there is little variability in the relationships of the left renal vein, abdominal aorta, and left renal artery. However, previous studies of the renal pedicle have documented a significant amount of variability in the anatomy of the left renal vein, calling the consistency of the regional anatomy into question. To determine the validity of using the left renal vein as an anatomic landmark, the renal vessels of 57 postmortem subjects were examined. Seven subjects with anomalies or pathology which distorted the regional anatomy were excluded from the study group. In the remaining 50 subjects, the relationship of the left renal vein to the origin of the left renal artery was determined. The left renal artery was directly beneath the left renal vein in 52%, below (caudal to) the corresponding vein in 14%, and above (craniad to) the corresponding vein in 34%. The mean distance between the midpoint of the origin of the left renal artery and the cephalad margin of the left renal vein was 3.1 mm (P = 0.034). These data validate the assumption that the left renal vein is a reliable anatomic landmark for locating the left renal artery and juxtarenal aorta in cases where anomalous vascular anatomy or previous retroperitoneal dissection are not present.