title: [Complete resection of a posterior mediastinal tumor after preoperative identification of artery of Adamkiewicz].
abstract: The thoracolumbar spinal cord receives its blood supply primarily from the artery of Adamkiewicz (AA), a branch of thoracolumbar intercostal arteries. Aortic cross-clamping during operation for descending aortic aneurysms can cause paraplegia due to spinal cord ischemia secondary to low blood flow through the AA. A 69-year-old woman was diagnosed with a left posterior mediastinal tumor measuring 66 mm. The tumor was adjacent to the thoracic aorta between Th10 to Th12 vertebral levels. Preoperative 3-dimensional computed tomography (3D-CT) imaging revealed 2 AAs originated from the 10th and 11th left intercostal arteries just near the tumor. The patient underwent a left thoracotomy and the 2 intercostal arteries were carefully dissected from the encapsulated tumor. Complete resection was safely achieved with preservation of the AAs. Pathology revealed a schwannoma. There were no complications. In performing thoracic surgery for posterior mediastinal tumors, it is important to identify the AAs preoperatively and preserve them.
authors.affiliation: Department of Thoracic Surgery, Sapporo City General Hospital, Sapporo, Japan.
authors.forename: Haruhiko
authors.initials: H
authors.lastname: Shiiya
authors.forename: Akihiko
authors.initials: A
authors.lastname: Tanaka
authors.forename: Motoki
authors.initials: M
authors.lastname: Sakuraba
authors.forename: Masanori
authors.initials: M
authors.lastname: Nakamura
authors.forename: Yui
authors.initials: Y
authors.lastname: Shibayama
authors.forename: Takahiro
authors.initials: T
authors.lastname: Tsuji
authors.forename: Yuichiro
authors.initials: Y
authors.lastname: Fukasawa
mesh_terms: D001158:Arteries / Q000601:surgery*; D005260:Female; D006801:Humans; D021621:Imaging, Three-Dimensional; D008479:Mediastinal Neoplasms / Q000098:blood supply / Q000000981:diagnostic imaging / Q000473:pathology / Q000601:surgery*; D008875:Middle Aged; D009442:Neurilemmoma / Q000098:blood supply / Q000000981:diagnostic imaging / Q000601:surgery*; D011300:Preoperative Care; D014057:Tomography, X-Ray Computed