Artery of Adamkiewicz

Artery: Artery of Adamkiewicz
Latin	rami spinales arteriae vertebralis
Supplies	lumbar enlargement of lower spinal cord[1]
Source	abdominal aorta, vertebral artery
Branches	anterior spinal artery[2]

In human anatomy, the Artery of Adamkiewicz is the largest anterior segmental medullary artery.^[3]

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 variation

Magnetic resonance angiography showing the artery of Adamkiewicz branching from the aorta (small vessel upper right corner). View from the right side.

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 treating a thoracic aortic aneurysm or a thoraco-abdominal aortic aneurysm.^[14] Its location can be identified with computed tomographic angiography.^[15]

Eponym

It is named for Albert Wojciech Adamkiewicz.^[16][17][18]

References

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. pp. 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. 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. http://www.ajnr.org/cgi/content/full/26/4/936. 
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. http://ptjournal.apta.org/content/81/6/1264.full. 
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. 
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. ^ 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. 
16. ^ 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. 
17. ^ synd/2233 at Who Named It?
18. ^ Kowalczyk, J (2002). "Albert Wojciech Adamkiewicz and his artery". South African medical journal 92 (9): 702. PMID 12382351. 

External links

• 00642 at CHORUS
• A video showing the Adamkiewicz artery can be seen here: AKA finding using OsiriX