Artery of Adamkiewicz explained

Artery of Adamkiewicz
Latin:rami spinales arteriae vertebralis
Branchfrom:Abdominal aorta, posterior intercostal artery
Branchto:Anterior spinal artery[1]
Supplies:Lumbar enlargement of lower spinal cord[2]

In human anatomy, the artery of Adamkiewicz (also arteria radicularis magna) is the largest anterior segmental medullary artery.[3] It typically arises from a 9th to 12th left posterior intercostal artery,[4] enters through the L2-L3 intervertebral foramen to join the anterior spinal artery and supply much of the inferior half of the spinal cord.[5]

The artery is named after Albert Wojciech Adamkiewicz (August 11, 1850 – October 31, 1921), a Polish pathologist born in Żerków. It has several other names, including:

Structure

The blood supply of the spinal cord is complex and highly variable.[10] In a study of approximately 70 people that examined the spinal cord's blood supply it was found that:[4]

  1. The Adamkiewicz artery sometimes arises from a lumbar vessel.
  2. In approximately 30% of people it arises from the right side.
  3. One quarter of people have two large anterior segmental medullary arteries.

In 75% of people, the artery of Adamkiewicz originates on the left side of the aorta between the T8 and L1 vertebral segments.[11]

In an extensive literature review, recognition of the AKA using CT and/or MR was achieved in 466 of 555 cases (83.96%) and in 384 (83.3%) cases the AKA originated from a left intercostal artery.[12]

Clinical significance

"Great radicular artery of Adamkiewicz… provides the major blood supply to the lumbar and sacral cord."[13]

When damaged or obstructed, it can result in a syndrome of spinal cord ischemia, similar to anterior spinal artery syndrome,[14] with loss of urinary and fecal continence and impaired motor function of the legs; sensory function is often preserved to a degree.

It is important to identify the location of the artery when surgically treating an aortic aneurysm to prevent damage which would result in insufficient blood supply to the spinal cord.[15] In bronchial artery embolization for treatment of massive hemoptysis, one of the most serious complications is inadvertent occlusion of the artery of Adamkiewicz.[16] Its location can be identified with computed tomographic angiography.[17]

History

It is named for Albert Wojciech Adamkiewicz.[18] [19]

External links

Notes and References

  1. Koshino . T . Murakami . G . Morishita . K . Mawatari . T . Abe . T . Does the adamkiewicz artery originate from the larger segmental arteries? . The Journal of Thoracic and Cardiovascular Surgery . 117 . 5 . 898–905 . 1999 . 10220681 . 10.1016/S0022-5223(99)70369-7. free .
  2. Milen . Mark T. . Bloom . David A. . Culligan . J. . Murasko . K. . Albert Adamkiewicz (1850-1921) - his artery and its significance for the retroperitoneal surgeon . World Journal of Urology . 17 . 3 . 168–70 . 1999 . 10418091 . 10.1007/s003450050126. 2027.42/42166 . free .
  3. Book: Moore, Keith. Essential Clinical Anatomy, Third Edition. 2007. Lippincott Williams & Wilkins. 978-0-7817-6274-8. 298. Anne Agur.
  4. Takase . K. . Sawamura . Y. . Igarashi . K. . Chiba . Y. . Haga . K. . Saito . H. . Takahashi . S. . 2002 . Demonstration of the Artery of Adamkiewicz at Multi- Detector Row Helical CT . Radiology . 223 . 1 . 39–45 . 10.1148/radiol.2231010513 . 11930046.
  5. Book: Patestas, Maria A. . A Textbook of Neuroanatomy . Gartner . Leslie P. . Wiley-Blackwell . 2016 . 978-1-118-67746-9 . 2nd . Hoboken, New Jersey . 70.
  6. Luyendijk W, Cohn B, Rejger V, Vielvoye GJ . The great radicular artery of Adamkiewicz in man. Demonstration of a possibility to predict its functional territory . Acta Neurochirurgica . 95 . 3–4 . 143–6 . 1988 . 3228004 . 10.1007/bf01790776.
  7. Alessandra . Biondi . Giuseppe K. . Ricciardia . Tierry . Faillot . Laurent . Capelle . Rémy . Van Effenterre . Jacques . Chiras . Hemangioblastomas of the lower spinal region: report of four cases with preoperative embolization and review of the literature . AJNR . 26 . 4 . 936–45 . 2005 . 15814949 .
  8. Nijenhuis RJ, Mull M, Wilmink JT, Thron AK, Backes WH . MR angiography of the great anterior radiculomedullary artery (Adamkiewicz artery) validated by digital subtraction angiography . AJNR . 27 . 7 . 1565–72 . 2006 . 16908582.
  9. Greathouse . David G. . Halle . John S. . Dalley . Arthur F. . Blood supply to the spinal cord . Physical Therapy . 81 . 6 . 1264–5 . 2001 . 10.1093/ptj/81.6.1264 . 11380281 . free .
  10. Melissano . G. . Civilini . E. . Bertoglio . L. . Calliari . F. . Campos Moraes Amato . A. . Chiesa . R. . Angio-CT Imaging of the Spinal Cord Vascularisation: A Pictorial Essay . European Journal of Vascular and Endovascular Surgery . 39 . 4 . 436–40 . 2010 . 20034815 . 10.1016/j.ejvs.2009.11.026. free .
  11. Lazorthes . Guy . Gouaze . Andrè . Zadeh . Jean O. . Jacques Santini . Jean . Lazorthes . Yves . Burdin . Phillipe . 1899816 . Arterial vascularization of the spinal cord . Journal of Neurosurgery . 35 . 253–62 . 1971 . 10.3171/jns.1971.35.3.0253 . 22046635 . 3.
  12. Melissano . G. . Bertoglio . L. . Civelli . V. . Moraes Amato . A.C. . Coppi . G. . Civilini . E. . Calori . G. . De Cobelli . F. . Del Maschio . A. . Chiesa . R. . Demonstration of the Adamkiewicz Artery by Multidetector Computed Tomography Angiography Analysed with the Open-Source Software OsiriX . European Journal of Vascular and Endovascular Surgery . 37 . 4 . 395–400 . 2009 . 19230726 . 10.1016/j.ejvs.2008.12.022. 8 . free .
  13. Book: Blumenfeld, Hal . Neuroanatomy Through Clinical Cases . 2nd . Sinauer Associates . Sunderland, Mass . 2010 . 978-0-87893-058-6.
  14. Wan . Innes Y. P. . Angelini . Gianni D. . Bryan . Alan J. . Ryder . Ian . Underwood . Malcolm J. . Prevention of spinal cord ischaemia during descending thoracic and thoracoabdominal aortic surgery . European Journal of Cardio-Thoracic Surgery . 19 . 2 . 203–13 . 2001 . 11167113 . 10.1016/S1010-7940(00)00646-1. free .
  15. Yoshioka . K. . Niinuma . H. . Ohira . A. . Nasu . K. . Kawakami . T. . Sasaki . M. . Kawazoe . K. . MR Angiography and CT Angiography of the Artery of Adamkiewicz: Noninvasive Preoperative Assessment of Thoracoabdominal Aortic Aneurysm . Radiographics . 23 . 5 . 1215–25 . 2003 . 12975511 . 10.1148/rg.235025031.
  16. Lopez. January. Lee. Hsin-Yi. Bronchial Artery Embolization for Treatment of Life-Threatening Hemoptysis. Seminars in Interventional Radiology. 23. 3. 2006. 223–229. 0739-9529. 10.1055/s-2006-948759. 21326768. 3036375.
  17. Nojiri . Junichi . Matsumoto . Koichi . Kato . Akira . Miho . Takahiro . Furukawa . Koujiro . Ohtsubo . Satoshi . Itoh . Tsuyoshi . Kudo . Sho . The Adamkiewicz artery: demonstration by intra-arterial computed tomographic angiography . European Journal of Cardio-Thoracic Surgery . 31 . 2 . 249–55 . 2007 . 17182250 . 10.1016/j.ejcts.2006.11.024. free .
  18. Adamkiewicz AA . Die Blutgefässe des menschlichen Rückenmarkes. II. Die Gefässe der Rückenmarksoberfläche . Sitzungsberichte der Kaiserlichen Akademie der Wissenschaften. Mathematisch-Naturwissenschaftliche Classe . 1882 . 85 . 101–30.
  19. Kowalczyk . J . Albert Wojciech Adamkiewicz and his artery . South African Medical Journal . 92 . 9 . 702 . 2002 . 12382351.

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