Extraanatomical revascularization of the artery of Adamkiewicz: anatomical study

Ann Vasc Surg. 2002 Nov;16(6):723-9. doi: 10.1007/s10016-001-0316-0. Epub 2002 Oct 31.

Abstract

Spinal cord ischemia is a major cause of complications after operative and endovascular treatment of descending thoracic or thoracoabdominal aortic aneurysms. Prior revascularization of the intercostal artery (IA) giving rise to the artery of Adamkiewicz (AA) using an artery of the thoracic wall would preserve circulation in the AA and allow obstruction of the IA at its origin. The purpose of this study was to determine the feasibility of revascularization of the IA giving rise to the AA using three thoracic wall arteries, i.e., lateral thoracic artery, thoracodorsal artery, and descending scapular artery. A total of 16 specimens from 8 cadavers (6 men and 2 women) were prepared. The length and diameter of the thoracic wall arteries were measured to ascertain the feasibility of revascularization of the IA giving rise to the AA. In addition, 12 preoperative spinal cord arteriograms were studied. We found that revascularization of the IA giving rise to the AA using thoracic wall arteries is feasible. This technique could be used to prevent spinal cord complications after treatment of descending thoracic or thoracoabdominal aortic aneurysms.

Publication types

  • Comparative Study
  • Evaluation Study

MeSH terms

  • Aged
  • Aged, 80 and over
  • Anastomosis, Surgical*
  • Aortic Aneurysm, Abdominal / surgery
  • Aortic Aneurysm, Thoracic / surgery
  • Aortic Dissection / surgery
  • Arteries / anatomy & histology
  • Arteries / surgery
  • Cervical Vertebrae
  • Disease Progression
  • Early Ambulation
  • Female
  • Humans
  • Intercostal Muscles / blood supply*
  • Male
  • Middle Aged
  • Models, Anatomic
  • Spinal Cord Ischemia / etiology
  • Spinal Cord Ischemia / prevention & control
  • Thoracic Arteries / anatomy & histology*
  • Thoracic Arteries / surgery*
  • Treatment Outcome
  • Vascular Surgical Procedures*
  • Vertebral Artery / anatomy & histology
  • Vertebral Artery / surgery