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Updated: Jan 8, 2026

Author Spotlight: Using Point-of-Care Ultrasound for Comprehensive Evaluation of the Abdominal Aorta
Published on: September 8, 2023
Challenges in Identifying and Interpreting Intercostal Branches of the Adamkiewicz Artery
Satoru Tomita1, Yoshimasa Seike1, Tatsuya Nishii2
1Departments of Cardiovascular Surgery, National Cerebral and Cardiovascular Center, Suita, Osaka, Japan.
Abstract:
An 82-year-old woman underwent zone 4 thoracic endovascular aortic repair (TEVAR) for a descending aortic aneurysm. Four years later, an additional TEVAR was performed for a type Ib endoleak. Preoperative computed tomography angiography (CTA) initially identified the intercostal artery branching of the Adamkiewicz artery (ICA-AKA) at the left 10th thoracic level, which was covered by a stent graft. Prior to the second TEVAR, CTA showed the ICA-AKA via the left first lumbar artery. Reevaluation of the ICA-AKA is important, particularly after coverage. Surgeons should interpret CTA findings carefully, as other arteries or veins may resemble the AKA.
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