Meta-Analysis of the Arterial Variations of the Suprarenal Arteries and Their Clinical Significance

Abstract

Aim: The suprarenal (adrenal) glands are supplied by a rich arterial network that typically arises from the inferior phrenic arteries (superior suprarenal), the abdominal aorta (middle suprarenal), and the renal arteries (inferior suprarenal). However, the frequency, diversity, and laterality of arterial variants vary considerably among individuals and populations, carrying important clinical implications for radiology, endovascular therapy, and retroperitoneal surgery. This study aims to provide reliable reference values for the literature by determining the arterial variations of the adrenal glands and their origins through a systematic meta-analysis method. Materials and Methods: In this study, published anatomical and radiological series were systematically reviewed and integrated into a purpose-built dataset prepared in Excel format. Following Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA) guidelines, records were screened in duplicate, data on right and left laterality as well as variant origins for each suprarenal arterial tier were extracted. Random?effects proportion meta-analyses, including heterogeneity, small?study, and sensitivity assessments were performed. Results: The findings showed that variants originating from the inferior phrenic and aortic sources were more frequent than those arising from mesenteric or gonadal trunks, and right–left asymmetry was evident. Across study designs and imaging modalities, considerable between-study heterogeneity persisted and was partly explained by methodology (cadaveric dissection versus multidetector CT angiography) and geography. Conclusions: In conclusion, these findings enhance the precision of preoperative vascular risk assessment for adrenal, renal, and para?aortic interventions and emphasize the need for standardized reporting of suprarenal arterial variants. © 2026, Selcuk University. All rights reserved.