Does the adamkiewicz artery originate from the larger segmental arteries?

Koshino, Tokuo; Murakami, Gen; Morishita, Kiyofumi; Mawatari, Tohru; Abe, Tomio

doi:10.1016/s0022-5223(99)70369-7

Cited by 137 publications

(84 citation statements)

References 15 publications

(7 reference statements)

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…In approximately 70% of cases, the AKA originates from an intercostal or lumbar artery on the left side of the vertebral column and most frequently between the vertebral levels T8 to L1. 14 The posterior spinal arteries are usually paired, course on the posterolateral surface of the spinal cord along its entire length, and may occasionally be discontinuous. Posterior spinal arteries and the corresponding posterior radiculomedullary supply typically are less than 0.5 mm in diameter and, at present, can only occasionally be depicted in vivo by catheter angiography.…”

Section: Vascular Anatomymentioning

confidence: 99%

Advances in Spinal Cord MR Angiography

Backes

Nijenhuis²

2008

AJNR Am J Neuroradiol

View full text Add to dashboard Cite

SUMMARY:Novel developments in MR angiography are reviewed that enable non-invasive clinical imaging of normal and abnormal vessels of the spinal cord. Current fast contrast-enhanced MR techniques are able 1) to visualize vessels supplying or draining the spinal cord and 2) to differentiate spinal cord arteries from veins. The localization of the Adamkiewicz artery, the largest artery supplying the thoracolumbar spinal cord, has become possible in a reproducible and reliable manner. Knowledge of the anatomic location of this artery and its arterial supplier may be of benefit in the work-up for aortic aneurysm surgery to reduce incidences of ischemic injury. Spinal cord MR angiography is ready to become a diagnostic tool that can compete with catheter angiography for detecting and localizing arterial feeders of vascular lesions and is strongly advised for use prior to invasive catheter angiography. Successful clinical application strongly relies on in depth knowledge of the complex spinal cord vasculature and skills in image postprocessing. Due to their small calibers, clinical imaging of spinal cord arteries and veins was until recently only possible using catheter angiography. MR imaging by virtue of its strong soft tissue contrast is widely applied in patients suspected of harboring spinal vascular abnormalities. Using MR imaging in these patients, the diagnosis was predominantly based on changes of the cord tissue appearance but not on direct visualization of abnormal vessels.1 Even today it is beyond doubt that catheter angiography is the ultimate imaging technique for diagnosing, localizing, and classifying spinal vascular lesions.2 Despite its superior spatial resolution and image quality, it has, however, several major drawbacks, because it is invasive, involves exposure to ionizing radiation, and has a small risk for major complications.3,4 Furthermore, it is time consuming, may require a number of diagnostic sessions, and can only be performed by experts. Moreover, catheter angiography can be difficult to perform in patients with aortic diseases, such as aortic aneurysms.4,5 For these reasons, new developments in spinal cord angiography were prompted.It was mainly from clinical research in aortic aneurysm surgery that the request came to develop noninvasive visualization of normal arteries supplying the spinal cord to avoid the risk of paraplegia induced by interruption or damaging of the spinal cord blood supply. Catheter angiography is regarded as especially unattractive, because it is relatively hazardous in these patients due to the potential dislocation of aortic thrombi and because its sensitivity in detection of the main arterial supplier of the thoracolumbar spinal cord, that is, the Adamkiewicz artery (AKA), is too variable and too low (43%-86% 4-6 ). Traditional MR angiographic techniques before 2000 were not able to depict normal intradural arteries and were restricted to the visualization of pathologically dilated arteries and veins.7 Recent advances in MR and CT angiography were first demons...

show abstract

Section: Vascular Anatomymentioning

confidence: 99%

Advances in Spinal Cord MR Angiography

Backes

Nijenhuis²

2008

AJNR Am J Neuroradiol

View full text Add to dashboard Cite

show abstract

“…Moreover, the angle between the GARV and the anterior spinal vein (ASV), called a "coat hook" shape, is wider than between the AKA and ASA, which is called a "hairpin turn" connection. 2,6 As has also been described in a specimen study, there may be approximately 6-14 anterior medullary arteries that contribute to the anterior spinal artery. In the thoracolumbar region, there is always a dominant great anterior medullary artery called the artery of Adamkiewicz.…”

Section: Discussionmentioning

confidence: 70%

“…6). 6 Secondly, the Adamkiewicz artery may be anatomically absent, in which case the thoracolumbar spinal cord is supplied with blood by intersegmental collateral arteries. A similar situation can occur when the AKA is functionally absent (e.g.…”

Section: Discussionmentioning

confidence: 99%

“…Moreover, because of a more limited field of view (FOV), segmental collaterals cannot be imaged. 6 Hyodoh et al reported an 84% detection rate of the AKA with multi-phase dynamic MRA, but only 48% in single-phase MR angiography, despite the use of a double dose of contrast material to obtain sufficient arterial opacification. 12 Nijenhuis et al also reported a very high AKA detection rate using two-phase dynamic MRA.…”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

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

Guziński

Bryl²,

Ziemińska

et al. 2017

Adv Clin Exp Med

View full text Add to dashboard Cite

show abstract

“…1 High variability of spinal cord feeding arteries was infallibly demonstrated in several species but was probably best documented in man. [2][3][4][5][6][7] The aim of this study was to contribute to the knowledge of arterial supply of the spinal cord of rabbits, with focus on thoracic and lumbar regions in which the surgical procedures are associated with the risk of serious neurological damage. At the same time, we would like to point to some variations in segmental arterial supply of the spinal cord in the respective regions.…”

Section: Introductionmentioning

confidence: 99%

Anatomical study of blood supply to the spinal cord in the rabbit

et al. 2010

View full text Add to dashboard Cite

Study design: The study was carried out in rabbit. Objective: To investigate the arterial blood supply of the spinal cord in rabbit as model in experimental spinal cord ischemia surgery. Setting: The study was carried out in the Department of Anatomy, Histology and Physiology, University of Veterinary Medicine and Pharmacy in Kosice, Slovak Republic. Methods: The study was carried out on 10 adult New Zealand white rabbits. We prepared corrosion casts of arterial system of spinal cord. Batson's corrosion casting kit no. 17 was used as a casting medium.Results: The presence of branches entering arteria spinalis ventralis in the thoracic region was observed in 71% of the cases on the left side and in 29% on the right side. In the lumbar region, leftsided branches were observed in 52% of the cases and right-sided in 48% of the cases. The artery of Adamkiewicz was present in 50% of the cases as left-sided and in 50% as right-sided. Conclusion: Documenting the anatomical variations in spinal cord blood supply in the rabbit will aid in the planning of future experimental studies and determining the clinical relevance on such studies.

show abstract

Does the adamkiewicz artery originate from the larger segmental arteries?

Abstract: This study provides evidence that, during operations on the thoracoabdominal aorta, the intercostal and/or lumbar arteries should be preserved, regardless of their diameter, to prevent postoperative paraplegia.

Cited by 137 publications

References 15 publications

Advances in Spinal Cord MR Angiography

Advances in Spinal Cord MR Angiography

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

Anatomical study of blood supply to the spinal cord in the rabbit

Contact Info

Product

Resources

About