title: Modification of a Standard Thoracoabdominal Incision to Preserve Collaterals to Adamkiewicz Artery.
abstract: We report a case of a 35-year-old male who underwent thoracoabdominal aortic repair of a chronic dissecting aortic aneurysm, Crawford extent II. Preoperative computed tomography showed thrombosis of almost all intercostal arteries. Precise diagnostic assessment demonstrated the Adamkiewicz artery originating from the left lateral thoracic artery and subscapular artery, which would have been at risk after using a standard Stoney's incision, thus potentially causing paraplegia or paraparesis due to spinal cord ischemia. We modified the lateral thoracic incision anteriorly and successfully preserved the collateral arteries without impairing the spinal cord function.
authors.affiliation: Division of Cardiovascular Surgery, Tohoku University, Sendai, Japan.
authors.forename: Shingo
authors.initials: S
authors.lastname: Takahara
authors.affiliation: Division of Cardiovascular Surgery, Tohoku University, Sendai, Japan.
authors.forename: Keisuke
authors.initials: K
authors.lastname: Kanda
authors.affiliation: Division of Cardiovascular Surgery, Tohoku University, Sendai, Japan.
authors.forename: Satoshi
authors.initials: S
authors.lastname: Kawatsu
authors.affiliation: Division of Cardiovascular Surgery, Tohoku University, Sendai, Japan.
authors.forename: Ichiro
authors.initials: I
authors.lastname: Yoshioka
authors.affiliation: Division of Cardiovascular Surgery, Tohoku University, Sendai, Japan.
authors.forename: Hidenori
authors.initials: H
authors.lastname: Fujiwara
authors.affiliation: Division of Cardiovascular Surgery, Tohoku University, Sendai, Japan.
authors.forename: Osamu
authors.initials: O
authors.lastname: Adachi
authors.affiliation: Division of Cardiovascular Surgery, Tohoku University, Sendai, Japan.
authors.forename: Masatoshi
authors.initials: M
authors.lastname: Akiyama
authors.affiliation: Division of Cardiovascular Surgery, Tohoku University, Sendai, Japan.
authors.forename: Kiichiro
authors.initials: K
authors.lastname: Kumagai
authors.affiliation: Division of Cardiovascular Surgery, Tohoku University, Sendai, Japan.
authors.forename: Shunsuke
authors.initials: S
authors.lastname: Kawamoto
authors.affiliation: Division of Diagnostic Radiology, Tohoku University, Sendai, Japan.
authors.forename: Hideki
authors.initials: H
authors.lastname: Ota
authors.affiliation: Division of Cardiovascular Surgery, Tohoku University, Sendai, Japan. Electronic address: yoshisaiki@med.tohoku.ac.jp.
authors.forename: Yoshikatsu
authors.initials: Y
authors.lastname: Saiki
mesh_terms: D000328:Adult; D000784:Aortic Dissection / Q000000981:diagnostic imaging / Q000601:surgery*; D017545:Aortic Aneurysm, Thoracic / Q000000981:diagnostic imaging / Q000601:surgery*; D002908:Chronic Disease; D000072226:Computed Tomography Angiography / Q000379:methods; D005500:Follow-Up Studies; D006801:Humans; D007431:Intraoperative Complications / Q000517:prevention & control*; D008297:Male; D011300:Preoperative Care / Q000379:methods; D018570:Risk Assessment; D013895:Thoracic Arteries / Q000002:abnormalities*; D016896:Treatment Outcome; D054079:Vascular Malformations / Q000000981:diagnostic imaging*; D014656:Vascular Surgical Procedures / Q000379:methods*