Artery of Adamkiewicz

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Artery of Adamkiewicz
Artery of Adamkiewicz CT scan OsiriX.jpg
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[2]
Supplies lumbar enlargement of lower spinal cord[1]
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:

  • Adamkiewicz artery
  • great radicular artery of Adamkiewicz[4]
  • major anterior segmental medullary artery
  • artery of the lumbar enlargement[5]
  • great anterior radiculomedullary artery[6]
  • great anterior segmental medullary artery[7]

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[edit]

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[edit]

"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[edit]

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

References[edit]

  1. ^ 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. 
  2. ^ 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. 
  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. ^ a b 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. [page needed]
  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[edit]