Detection of the Adamkiewiczartery
in computed tomography of the thorax and abdomen

Guziński, Maciej; Bryl, Maciej; Ziemińska, Katarzyna; Wolny, Kamila; Sąsiadek, Marek; Garcarek, Jerzy

doi:10.17219/acem/62788

Cited by 11 publications

(4 citation statements)

References 18 publications

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“…The characteristics of the included studies are presented in Table 1. A total of 60 studies (4317 subjects with AKA) published between 1989 [14] and 2017 [15] were included [1–10, 14–62]. The studies originated from North America, Asia and Europe, and from ten different countries.…”

Section: Resultsmentioning

confidence: 99%

Artery of Adamkiewicz: a meta-analysis of anatomical characteristics

et al. 2019

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Purpose The artery of Adamkiewicz (AKA) provides the major blood supply to the anterior thoracolumbar spinal cord and iatrogenic injury or inadequate reconstruction of this vessel during vascular and endovascular surgery can result in postoperative neurological deficit due to spinal cord ischemia. The aim of this study was to provide comprehensive data on the prevalence and anatomical characteristics of the AKA. Methods An extensive search was conducted through the major electronic databases to identify eligible articles. Data extracted included study type, prevalence of the AKA, gender, number of AKA per patient, laterality, origin based on vertebral level, side of origin, morphometric data, and ethnicity subgroups. Results A total of 60 studies ( n = 5437 subjects) were included in the meta-analysis. Our main findings revealed that the AKA was present in 84.6% of the population, and patients most frequently had a single AKA (87.4%) on the left side (76.6%) originating between T8 and L1 (89%). Conclusion As an AKA is present in the majority of the population, caution should be taken during vascular and endovascular surgical procedures to avoid injury or ensure proper reconstruction. All surgeons operating in the thoracolumbar spinal cord should have a thorough understanding of the anatomical characteristics and surgical implications of an AKA. Electronic supplementary material The online version of this article (10.1007/s00234-019-02207-y) contains supplementary material, which is available to authorized users.

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Section: Resultsmentioning

confidence: 99%

Artery of Adamkiewicz: a meta-analysis of anatomical characteristics

et al. 2019

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“…This change in the preoperative diagnostic workup was prompted by one patient who developed paraplegia postoperatively—a catastrophic event for the patient and members of the patient’s family and medical team. The radiographic CTA protocols employed in this study have been published and are commonplace [ 26 , 32 ]. The value of MRI angiography in comparison to CTA in the study of the AKA system is currently being evaluated [ 27 ].…”

Section: Discussionmentioning

confidence: 99%

“…The value of MRI angiography in comparison to CTA in the study of the AKA system is currently being evaluated [ 27 ]. Since the AKA may not be present in up to 10 percent of patients, [ 8 ] the radiologist must identify in the arterial study the intercostal arteries in their entirety, which typically also is associated with filling of the radicular arteries with contrast dye [ 26 ]. It may not be possible to say with certainty if an AKA is present or not if a deviation from this interventional radiology protocol occurred.…”

Section: Discussionmentioning

confidence: 99%

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Identification of the Magna Radicular Artery Entry Foramen and Adamkiewicz System: Patient Selection for Open versus Full-Endoscopic Thoracic Spinal Decompression Surgery

Vargas

Olinveira²,

Moscatelli³

et al. 2023

JPM

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Background: Casually cauterizing the radicular magna during routine thoracic discectomy may have dire consequences. Methods: We performed a retrospective observational cohort study on patients scheduled for decompression of symptomatic thoracic herniated discs and spinal stenosis who underwent a preoperative computed tomography angiography (CTA) to assess the surgical risks by anatomically defining the foraminal entry level of the magna radicularis artery into the thoracic spinal cord and its relationship to the surgical level. Results: Fifteen patients aged 58.53 ± 19.57, ranging from 31 to 89 years, with an average follow-up of 30.13 ± 13.42 months, were enrolled in this observational cohort study. The mean preoperative VAS for axial back pain was VAS of 8.53 ± 2.06 and reduced to a postoperative VAS of 1.60 ± 0.92 (p < 0.0001) at the final follow-up. The Adamkiewicz was most frequently found at T10/11 (15.4%), T11/12 (23.1%), and T9/10 (30.8%). There were eight patients where the painful pathology was found far from the AKA foraminal entry-level (type 1), three patients with near location (type 2), and another four patients needing decompression at the foraminal (type 3) entry-level. In five of the fifteen patients, the magna radicularis entered the spinal canal on the ventral surface of the exiting nerve root through the neuroforamen at the surgical level requiring a change of surgical strategy to prevent injury to this important contributor to the spinal cord’s blood supply. Conclusions: The authors recommend stratifying patients according to the proximity of the magna radicularis artery to the compressive pathology with CTA to assess the surgical risk with targeted thoracic discectomy methods.

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