Artery of Adamkiewicz

Artery of Adamkiewicz

Coronal slab volume rendering image of CT aortography shows artery of Adamkiewicz entering spinal canal(arrowheads) and joining the anterior spinal artery (arrows) after a hairpin turn.
Details
Latin rami spinales arteriae vertebralis
Source
 abdominal aorta, posterior intercostal artery
Branches
 anterior spinal artery[1]
Supplies lumbar enlargement of lower spinal cord[2]
Dorlands
/Elsevier		 r_02/12692029
Anatomical terminology

In human anatomy, the artery of Adamkiewicz (also arteria radicularis magna) is the largest anterior segmental medullary artery.[3] The artery is named after Albert Wojciech Adamkiewicz (August 11, 1850 – October 31, 1921) a Polish-Jewish pathologist born in Żerków.

It has several other names, including:

It typically arises from a left posterior intercostal artery, which branches from the aorta, and supplies the lower two thirds of the spinal cord via the anterior spinal artery.[8]

Anatomical variations

The spinal cord vasculature has a complex and highly variable anatomy.[9] In a study of approximately 70 people that examined the spinal cord's blood supply it was found that:[8]

  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.[10]

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.[11]

Clinical significance

"Great radicular artery of Adamkiewicz… provides the major blood supply to the lumbar and sacral cord."[12]

When damaged or obstructed, it can result in anterior spinal artery syndrome,[13] 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.[14] In bronchial artery embolization for treatment of massive hemoptysis, one of the most serious complications is inadvertent occlusion of the artery of Adamkiewicz.[15] Its location can be identified with computed tomographic angiography.[16]

Eponym

It is named for Albert Wojciech Adamkiewicz.[17][18][19]

References

  1. ↑ Koshino, T; Murakami, G; Morishita, K; Mawatari, T; Abe, T (1999). "Does the adamkiewicz artery originate from the larger segmental arteries?". The Journal of Thoracic and Cardiovascular Surgery 117 (5): 898–905. doi:10.1016/S0022-5223(99)70369-7. PMID 10220681.
  2. ↑ Milen, Mark T.; Bloom, David A.; Culligan, J.; Murasko, K. (1999). "Albert Adamkiewicz (1850-1921) - his artery and its significance for the retroperitoneal surgeon". World Journal of Urology 17 (3): 168–70. doi:10.1007/s003450050126. PMID 10418091.
  3. ↑ Moore, Keith; Anne Agur (2007). Essential Clinical Anatomy, Third Edition. Lippincott Williams & Wilkins. p. 298. ISBN 0-7817-6274-X.
  4. ↑ Luyendijk W, Cohn B, Rejger V, Vielvoye GJ (1988). "The great radicular artery of Adamkiewicz in man. Demonstration of a possibility to predict its functional territory". Acta neurochirurgica 95 (3–4): 143–6. doi:10.1007/bf01790776. PMID 3228004.
  5. ↑ Biondi, Alessandra; Ricciardia, Giuseppe K.; Faillot, Tierry; Capelle, Laurent; Van Effenterre, Rémy; Chiras, Jacques (2005). "Hemangioblastomas of the lower spinal region: report of four cases with preoperative embolization and review of the literature". AJNR 26 (4): 936–45. PMID 15814949.
  6. ↑ Nijenhuis RJ, Mull M, Wilmink JT, Thron AK, Backes WH (2006). "MR angiography of the great anterior radiculomedullary artery (Adamkiewicz artery) validated by digital subtraction angiography". AJNR 27 (7): 1565–72. PMID 16908582.
  7. ↑ Greathouse, David G.; Halle, John S.; Dalley, Arthur F. (2001). "Blood supply to the spinal cord". Physical therapy 81 (6): 1264–5. PMID 11380281.
  8. ↑ 8.0 8.1 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. doi:10.1148/radiol.2231010513. PMID 11930046.
  9. ↑ Melissano, G.; Civilini, E.; Bertoglio, L.; Calliari, F.; Campos Moraes Amato, A.; Chiesa, R. (2010). "Angio-CT Imaging of the Spinal Cord Vascularisation: A Pictorial Essay". European Journal of Vascular and Endovascular Surgery 39 (4): 436–40. doi:10.1016/j.ejvs.2009.11.026. PMID 20034815.
  10. ↑ Lazorthes, Guy; Gouaze, Andrè; Zadeh, Jean O.; Jacques Santini, Jean; Lazorthes, Yves; Burdin, Phillipe (1971). "Arterial vascularization of the spinal cord". Journal of Neurosurgery 35 (3): 253–62. doi:10.3171/jns.1971.35.3.0253. PMID 22046635.
  11. ↑ Melissano, G.; Bertoglio, L.; Civelli, V.; Moraes Amato, A.C.; Coppi, G.; Civilini, E.; Calori, G.; De Cobelli, F. et al. (2009). "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. doi:10.1016/j.ejvs.2008.12.022. PMID 19230726.
  12. ↑ Blumenfeld, Hal (2010). Neuroanatomy Through Clinical Cases (2nd ed.). Sunderland, Mass: Sinauer Associates. ISBN 978-0-87893-058-6.
  13. ↑ Wan, Innes Y. P.; Angelini, Gianni D.; Bryan, Alan J.; Ryder, Ian; Underwood, Malcolm J. (2001). "Prevention of spinal cord ischaemia during descending thoracic and thoracoabdominal aortic surgery". European Journal of Cardio-Thoracic Surgery 19 (2): 203–13. doi:10.1016/S1010-7940(00)00646-1. PMID 11167113.
  14. ↑ Yoshioka, K.; Niinuma, H.; Ohira, A.; Nasu, K.; Kawakami, T.; Sasaki, M.; Kawazoe, K. (2003). "MR Angiography and CT Angiography of the Artery of Adamkiewicz: Noninvasive Preoperative Assessment of Thoracoabdominal Aortic Aneurysm". Radiographics 23 (5): 1215–25. doi:10.1148/rg.235025031. PMID 12975511.
  15. ↑ Lopez, January; Lee, Hsin-Yi (2006). "Bronchial Artery Embolization for Treatment of Life-Threatening Hemoptysis". Seminars in Interventional Radiology 23 (3): 223–229. doi:10.1055/s-2006-948759. ISSN 0739-9529.
  16. ↑ Nojiri, Junichi; Matsumoto, Koichi; Kato, Akira; Miho, Takahiro; Furukawa, Koujiro; Ohtsubo, Satoshi; Itoh, Tsuyoshi; Kudo, Sho (2007). "The Adamkiewicz artery: demonstration by intra-arterial computed tomographic angiography". European Journal of Cardio-Thoracic Surgery 31 (2): 249–55. doi:10.1016/j.ejcts.2006.11.024. PMID 17182250.
  17. ↑ Adamkiewicz AA (1882). "Die Blutgefässe des menschlichen Rückenmarkes. II. Die Gefässe der Rückenmarksoberfläche". Sitzungsberichte der Kaiserlichen Akademie der Wissenschaften. Mathematisch-Naturwissenschaftliche Classe 85: 101–30.
  18. ↑ synd/2233 at Who Named It?
  19. ↑ Kowalczyk, J (2002). "Albert Wojciech Adamkiewicz and his artery". South African medical journal 92 (9): 702. PMID 12382351.

External links