左肾动脉
Arteria renalis sinistri
定义
左肾动脉是腹主动脉的一对主要分支，负责向左肾输送动脉血液。它通常起自腹主动脉的外侧或后外侧壁，起始水平最常见于第1腰椎（L1）下缘与第2腰椎（L2）上缘之间。左肾动脉的起点通常略低于右肾动脉，走行方向近乎水平或略向下倾斜，指向肾门。[1][3]
在横断面上，左肾动脉最常起自主动脉的后外侧或外侧壁，而右肾动脉则更多起自前外侧壁。左肾动脉行经左肾静脉、胰体及脾静脉的后方，经腰大肌前方后抵达肾门。[4-6] 由于腹主动脉位置更靠近左肾，左肾动脉的初始行程通常较右肾动脉更短、更为直接。[7]
左肾动脉抵达肾门后，通常分为前段支与后段支，两者再进一步分支以供应肾实质。变异情况较为常见，包括早期分支、副肾动脉，以及段支数目与分布模式的差异。[8-9] 左肾动脉的平均直径约为 5.4 mm，平均长度约为 35 mm，但上述数值可因患者解剖结构及肾功能状态而有所不同。[7]
參考資料
1.Anatomic Variation in the Origin of the Main Renal Arteries: Spiral CTA Evaluation.Beregi JP, Mauroy B, Willoteaux S, et al.European Radiology. 1999;9(7):1330-4. doi:10.1007/s003300050843.
2.Variations of Origin of the Renal Artery: A Review Covering 403 Aortographies.Aubert J, Koumare K.European Urology. 1975;1(4):182-8.
3.Anatomic Patterns of Distribution of the Renal Arteries' Origin From the Aorta.Mazzaccaro D, Avishay DM, Righini PC, et al.Annals of Vascular Surgery. 2025;110(Pt A):414-422. doi:10.1016/j.avsg.2024.03.035.
4.Renal Artery Origins: Location and Distribution in the Transverse Plane at CT.Verschuyl EJ, Kaatee R, Beek FJ, et al.Radiology. 1997;203(1):71-5. doi:10.1148/radiology.203.1.9122418.
5.Origin and Initial Course of the Renal Arteries: A Radiological Study.Garcier JM, De Fraissinette B, Filaire M, et al.Surgical and Radiologic Anatomy : SRA. 2001;23(1):51-5. doi:10.1007/s00276-001-0051-9.
6.Guidelines for Noninvasive Vascular Laboratory Testing: A Report From the American Society of Echocardiography and the Society of Vascular Medicine and Biology.Gerhard-Herman M, Gardin JM, Jaff M, et al.Journal of the American Society of Echocardiography : Official Publication of the American Society of Echocardiography. 2006;19(8):955-72. doi:10.1016/j.echo.2006.04.019.
7.Renal Artery Anatomy Assessed by Quantitative Analysis of Selective Renal Angiography in 1,000 Patients With Hypertension.Lauder L, Ewen S, Tzafriri AR, et al.EuroIntervention : Journal of EuroPCR in Collaboration With the Working Group on Interventional Cardiology of the European Society of Cardiology. 2018;14(1):121-128. doi:10.4244/EIJ-D-18-00112.
8.Anatomical Variability of Kidney Arterial Vasculature Based on Zonal and Segmental Topography.Kafarov ES, Miltykh I, Dmitriev AV, Zenin OK.Heliyon. 2023;9(4):e15315. doi:10.1016/j.heliyon.2023.e15315.
9.Cadaveric Study of Arterial Renal Anatomy and Its Surgical Implications in Partial Nephrectomy.Bouzouita A, Saadi A, Hermi A, et al.Surgical and Radiologic Anatomy : SRA. 2021;43(9):1449-1459. doi:10.1007/s00276-021-02769-8.
10.Renal Arteries Revisited: Anatomy, Pathologic Entities, and Implications for Endovascular Management.White RD, Moore KS, Salahia MG, et al.Radiographics : A Review Publication of the Radiological Society of North America, Inc. 2021 May-Jun;41(3):909-928. doi:10.1148/rg.2021200162.
11.Gray's Anatomy (20th U.S. edition of Gray's Anatomy of the Human Body, published in 1918 – from http://www.bartleby.com/107/).
