title: Extraanatomical revascularization of the artery of Adamkiewicz: anatomical study.
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.
authors.affiliation: Service de Chirurgie Vasculaire et Service de Radiologie, Hôpital de la Timone, Marseilles, France.
authors.forename: Serguei
authors.initials: S
authors.lastname: Malikov
authors.forename: Eugenio
authors.initials: E
authors.lastname: Rosset
authors.forename: Nikolaos
authors.initials: N
authors.lastname: Paraskevas
authors.forename: Pierre-Edouard
authors.initials: PE
authors.lastname: Magnan
authors.forename: Mathieu
authors.initials: M
authors.lastname: Poirier
authors.forename: Jean-Michel
authors.initials: JM
authors.lastname: Bartoli
authors.forename: Pierre
authors.initials: P
authors.lastname: Champsaur
authors.forename: Jean-Pierre
authors.initials: JP
authors.lastname: Ribal
authors.forename: Gérard
authors.initials: G
authors.lastname: Glanddier
authors.forename: Alain
authors.initials: A
authors.lastname: Branchereau
mesh_terms: 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