Extraanatomical revascularization of the artery of Adamkiewicz: anatomical study.
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.
Malikov
Serguei
S
Service de Chirurgie Vasculaire et Service de Radiologie, Hôpital de la Timone, Marseilles, France.
Rosset
Eugenio
E
Paraskevas
Nikolaos
N
Magnan
Pierre-Edouard
PE
Poirier
Mathieu
M
Bartoli
Jean-Michel
JM
Champsaur
Pierre
P
Ribal
Jean-Pierre
JP
Glanddier
Gérard
G
Branchereau
Alain
A
D000368:Aged; D000369:Aged, 80 and over; D000714:Anastomosis, Surgical; D000784:Aortic Dissection / Q000601:surgery; D017544:Aortic Aneurysm, Abdominal / Q000601:surgery; D017545:Aortic Aneurysm, Thoracic / Q000601:surgery; D001158:Arteries / Q000033:anatomy & histology / Q000601:surgery; D002574:Cervical Vertebrae; D018450:Disease Progression; D004434:Early Ambulation; D005260:Female; D006801:Humans; D007366:Intercostal Muscles / Q000098:blood supply*; D008297:Male; D008875:Middle Aged; D008953:Models, Anatomic; D020760:Spinal Cord Ischemia / Q000209:etiology / Q000517:prevention & control; D013895:Thoracic Arteries / Q000033:anatomy & histology* / Q000601:surgery*; D016896:Treatment Outcome; D014656:Vascular Surgical Procedures; D014711:Vertebral Artery / Q000033:anatomy & histology / Q000601:surgery