title: A review of the anatomy and clinical significance of adrenal veins.
abstract: The adrenal veins may present with a multitude of anatomical variants, which surgeons must be aware of when performing adrenalectomies. The adrenal veins originate during the formation of the prerenal inferior vena cava (IVC) and are remnants of the caudal portion of the subcardinal veins, cranial to the subcardinal sinus in the embryo. The many communications between the posterior cardinal, supracardinal, and subcardinal veins of the primordial venous system provide an explanation for the variable anatomy. Most commonly, one central vein drains each adrenal gland. The long left adrenal vein joins the inferior phrenic vein and drains into the left renal vein, while the short right adrenal vein drains immediately into the IVC. Multiple variations exist bilaterally and may pose the risk of surgical complications. Due to the potential for collaterals and accessory adrenal vessels, great caution must be taken during an adrenalectomy. Adrenal venous sampling, the gold standard in diagnosing primary hyperaldosteronism, also requires the clinician to have a thorough knowledge of the adrenal vein anatomy to avoid iatrogenic injury. The adrenal vein acts as an important conduit in portosystemic shunts, thus the nature of the anatomy and hypercoagulable states pose the risk of thrombosis.
authors.affiliation: Department of Anatomical Sciences, School of Medicine, St. George's University, Grenada, West Indies.
authors.forename: Alper
authors.initials: A
authors.lastname: Cesmebasi
authors.forename: Maira
authors.initials: M
authors.lastname: Du Plessis
authors.forename: Mark
authors.initials: M
authors.lastname: Iannatuono
authors.forename: Sameer
authors.initials: S
authors.lastname: Shah
authors.forename: R Shane
authors.initials: RS
authors.lastname: Tubbs
authors.forename: Marios
authors.initials: M
authors.lastname: Loukas
mesh_terms: D000311:Adrenal Glands / Q000098:blood supply*; D057510:Endovascular Procedures / Q000009:adverse effects; D006801:Humans; D006929:Hyperaldosteronism / Q000175:diagnosis; D007049:Iatrogenic Disease / Q000517:prevention & control; D012082:Renal Veins / Q000033:anatomy & histology* / Q000293:injuries; D014680:Veins / Q000033:anatomy & histology / Q000293:injuries; D014682:Vena Cava, Inferior / Q000033:anatomy & histology* / Q000293:injuries
keywords: adrenal variation; adrenal vein thrombosis; adrenal venous sampling; adrenalectomy complications; embryology; portosystemic shunt