The Role of Spinal Angiography in Operations on the Thoracic Aorta: Myth or Reality?

Heinemann, Markus K.; Brassel, Friedhelm; Herzog, Thomas; Dresler, Christoph; Becker, H.; Borst, H. G.

doi:10.1016/s0003-4975(97)01239-3

Cited by 70 publications

(42 citation statements)

References 19 publications

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“…The detection rate of the AKA by selective spinal angiography has been reported to be 65-86% [6,7]. However, selective spinal angiography is time-consuming, technically difficult to perform, and may be hazardous.…”

Section: Introductionmentioning

confidence: 99%

Demonstration of the Adamkiewicz artery in patients with descending or thoracoabdominal aortic aneurysm: optimization of contrast-medium application for 64-detector-row CT angiography

Utsunomiya

Yamashita

et al. 2008

Eur Radiol

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Our aim was to prospectively investigate the contrast agent concentration and the infusion rate to obtain optimal images of the Adamkiewicz artery by 64-row MDCT. Eighty patients were divided into four groups based on the following protocol: A, 100 mL of 300 mg I/mL at 5.0 mL/s; B, 100 mL of 350 mg I/mL at 5.0 mL/s; C, 100 mL of 300 mg I/mL at 3.5 mL/s; D, 100 mL of 350 mg I/mL at 3.5 mL/s. Quantitative evaluation was performed by calculating mean aortic attenuation value from T5 to L3 level. Visual evaluation of the Adamkiewicz artery was also performed. In a quantitative evaluation, the rapid injection (A, 473.4 +/- 82.6 HU; B, 506.7 +/- 71.9 HU) was significantly superior to the slow injection (C, 371.3 +/- 65.1 HU; D, 391.5 +/- 60.8 HU). In a visual evaluation, the Adamkiewicz artery was assessable in 15 of 20 (75%), 16 of 20 (80%), 9 of 20 (45%), and 10 of 20 (50%) patients in groups A, B, C, and D, respectively. The injection protocol of 1.75 g iodine/s provides both the adequate aortic attenuation of more than 450 HU to assess the Adamkiewicz artery and the best visualization of the Adamkiewicz artery in 64-row MDCT.

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Section: Introductionmentioning

confidence: 99%

Demonstration of the Adamkiewicz artery in patients with descending or thoracoabdominal aortic aneurysm: optimization of contrast-medium application for 64-detector-row CT angiography

Utsunomiya

Yamashita

et al. 2008

Eur Radiol

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“…7 The most reliable way to visualize the AKA is selective intercostal arterial angiography, the detection rate of which is 43%-86%. [8][9][10][11][12] However, selective angiography is time consuming, and complications including spinal cord injury can develop. 10,11 Recently, MR angiography (MRA) [13][14][15][16][17][18] and CT angiography (CTA) [17][18][19][20][21] have been used to visualize the AKA less invasively with reported detection rates of 67%-93% and 68%-90%, respectively.…”

mentioning

confidence: 99%

Preoperative Visualization of the Artery of Adamkiewicz by Intra-Arterial CT Angiography

Uotani¹,

Yamada²,

Kono³

et al. 2008

American Journal of Neuroradiology

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BACKGROUND AND PURPOSE:CT and MR angiographies have been reported to visualize the artery of Adamkiewicz (AKA) noninvasively to prevent spinal cord ischemia in surgery of thoracic descending aortic aneurysms. The purpose of this work was to compare the usefulness of CT angiography (CTA) with intra-arterial contrast injection (IACTA) with that of conventional CTA with intravenous contrast injection (IVCTA).

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“…Several other causes have also been identified: vascular malformation of the spine and spinal cord, narrow lumbar spinal canal, disk herniation, coagulopathy, embolic cardiopathy, vasculitis, and systemic lupus erythematosus. [3][4][5][6] We now report an additional cause: transient paraplegia due to anatomic factors. We previously reported two cases, 7 and though it was a rare and anecdotic cause of paraplegia, a third recent case prompted us to report this cause of paraplegia as it is not yet well known.…”

Section: Discussionmentioning

confidence: 99%

Paraplegia with lumbar artery compression by the diaphragmatic crus

Batt

Rogopoulos

Benchimol

et al. 2008

Journal of Vascular Surgery

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The authors report three cases of transient and recurrent paraplegia due to compression of the second right lumbar artery by the diaphragmatic crus. Circumstances of appearance are suggestive when paraplegia occurs in dorsolumbar hyperlordosis and low cardiac output is an associated hemodynamic risk factor. Selective medullary arteriography is indispensable for diagnosis and can demonstrate three signs: an anterior spinal dorsolumbar artery (artery of Adamkiewicz) that does not descend to the conus medullaris; posterior spinal arteries arising from the second lumbar arteries that vascularize the conus medullaris; existence of a tight stenosis on the second right lumbar artery that is aggravated during dynamic maneuvers. Section of the right diaphragmatic crus and release of the second right lumbar artery from the aorta to the fibrous arcade of the psoas permits definitive cure of symptoms.

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The Role of Spinal Angiography in Operations on the Thoracic Aorta: Myth or Reality?

Cited by 70 publications

References 19 publications

Demonstration of the Adamkiewicz artery in patients with descending or thoracoabdominal aortic aneurysm: optimization of contrast-medium application for 64-detector-row CT angiography

Demonstration of the Adamkiewicz artery in patients with descending or thoracoabdominal aortic aneurysm: optimization of contrast-medium application for 64-detector-row CT angiography

Preoperative Visualization of the Artery of Adamkiewicz by Intra-Arterial CT Angiography

Paraplegia with lumbar artery compression by the diaphragmatic crus

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