Artery of Adamkiewicz

Nomenclature

The artery is generally eponymic, but it has several other names, including:

• great radicular artery of Adamkiewicz
• major anterior segmental medullary artery
• artery of the lumbar enlargement
• great anterior radiculomedullary artery
• great anterior segmental medullary artery
• great ventral radicular artery

Anatomy

The artery has a characteristic "hairpin" turn on the cord surface as it first courses superiorly, then turns inferiorly. In 75% of people, it originates on the left side of the aorta between the T8 and L1 vertebral segments. In addition to being able to be either right or left-sided, the vessel can arise from a lumbar artery instead of from the aorta.

In an extensive literature review, recognition of the AKA using CT and/or MR was achieved in 466 of 555 cases (83.96%) and in 384 (83.3%) cases the AKA originated from a left intercostal artery.

Clinical significance

The artery provides blood supply to the front two-thirds of the lumbar and sacral cord. When damaged or obstructed, it can result in a syndrome of spinal cord ischemia, similar to anterior spinal artery syndrome, with loss of urinary and fecal continence and impaired motor function of the legs; sensory function is often preserved to a degree.

It is important to identify the location of the artery when surgically treating an aortic aneurysm to prevent damage which would result in a loss of blood supply to the spinal cord.

In bronchial artery embolization for treatment of massive lung bleeding, one of the most serious complications is to lose blood flow to the spinal cord caused by accidental closure of the artery of Adamkiewicz. Its location can be identified with computed tomographic angiography.

History

It is named for Albert Wojciech Adamkiewicz.

References

References

1. (1999). "Does the adamkiewicz artery originate from the larger segmental arteries?". The Journal of Thoracic and Cardiovascular Surgery.
2. (1999). "Albert Adamkiewicz (1850-1921) - his artery and its significance for the retroperitoneal surgeon". World Journal of Urology.
3. Moore, Keith. (2007). "Essential Clinical Anatomy, Third Edition". Lippincott Williams & Wilkins.
4. (October 2006). "MR angiography and CT angiography of the artery of Adamkiewicz: state of the art.". Radiographics.
5. (2002). "Demonstration of the Artery of Adamkiewicz at Multi- Detector Row Helical CT". Radiology.
6. (2016). "A Textbook of Neuroanatomy". Wiley-Blackwell.
7. (1988). "The great radicular artery of Adamkiewicz in man. Demonstration of a possibility to predict its functional territory". Acta Neurochirurgica.
8. (2005). "Hemangioblastomas of the lower spinal region: report of four cases with preoperative embolization and review of the literature". AJNR.
9. (2006). "MR angiography of the great anterior radiculomedullary artery (Adamkiewicz artery) validated by digital subtraction angiography". AJNR.
10. (2001). "Blood supply to the spinal cord". Physical Therapy.
11. (1971). "Arterial vascularization of the spinal cord". Journal of Neurosurgery.
12. (2009). "Demonstration of the Adamkiewicz Artery by Multidetector Computed Tomography Angiography Analysed with the Open-Source Software OsiriX". European Journal of Vascular and Endovascular Surgery.
13. Blumenfeld, Hal. (November 2010). "Neuroanatomy Through Clinical Cases". Sinauer Associates.
14. (2001). "Prevention of spinal cord ischaemia during descending thoracic and thoracoabdominal aortic surgery". European Journal of Cardio-Thoracic Surgery.
15. (2003). "MR Angiography and CT Angiography of the Artery of Adamkiewicz: Noninvasive Preoperative Assessment of Thoracoabdominal Aortic Aneurysm". Radiographics.
16. (2006). "Bronchial Artery Embolization for Treatment of Life-Threatening Hemoptysis". Seminars in Interventional Radiology.
17. (2007). "The Adamkiewicz artery: demonstration by intra-arterial computed tomographic angiography". European Journal of Cardio-Thoracic Surgery.
18. Adamkiewicz AA. (1882). "Die Blutgefässe des menschlichen Rückenmarkes. II. Die Gefässe der Rückenmarksoberfläche". Sitzungsberichte der Kaiserlichen Akademie der Wissenschaften. Mathematisch-Naturwissenschaftliche Classe.
19. {{WhoNamedIt. synd. 2233
20. (2002). "Albert Wojciech Adamkiewicz and his artery". South African Medical Journal.