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Utilizing a Cranial Window to Visualize the Middle Cerebral Artery During Endothelin-1 Induced Middle Cerebral Artery Occlusion
07:43

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Another blood supply to Adamkiewicz's artery

Junetsu Akasaka1, Masahiro Sakurai, Kei Takase

  • 1Department of Cardiovascular Surgery, Tohoku University Graduate School of Medicine, Sendai, Japan.

The Japanese Journal of Thoracic and Cardiovascular Surgery : Official Publication of the Japanese Association for Thoracic Surgery = Nihon Kyobu Geka Gakkai Zasshi
|October 30, 2004
PubMed

Insights

Endovascular stent-grafting for aortic dissection can compromise Adamkiewicz

Area of Science:

  • Vascular surgery
  • Neurology
  • Radiology

Background:

  • Chronic aortic dissection poses risks for spinal cord perfusion.
  • Endovascular stent-grafting is a treatment option for aortic dissection.
  • Adamkiewicz' artery (arteria radicularis magna) is crucial for spinal cord blood supply.

Observation:

  • A 76-year-old man with chronic aortic dissection underwent stent-grafting.
  • Preoperative CT identified Adamkiewicz' artery origin.
  • Intraoperative monitoring showed no motor evoked potential changes.
  • Postoperative CT revealed stent-graft occlusion of Adamkiewicz' artery ostium.

Findings:

  • Despite ostial occlusion, the distal Adamkiewicz' artery remained enhanced.
  • This suggests a functional collateral network supplied the artery.
  • Motor evoked potentials remained stable, indicating preserved spinal cord perfusion.

Implications:

  • Spinal cord perfusion may be maintained via collateral pathways after stent-grafting.
  • This finding is crucial for managing patients with aortic dissection.
  • Further research into collateral networks is warranted to optimize surgical outcomes.

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