Artery of Adamkiewicz

Template:Short description Template:Infobox artery In human anatomy, the artery of Adamkiewicz (also arteria radicularis magna) is the largest anterior segmental medullary artery and the dominant segmental feeding vessel to the thoracic cord, supplying the anterior aspect of the cord (from T8 to the conus medullaris) via the anterior spinal artery.<ref name=Moore298>Template:Cite book</ref> It is a radiculomedullary artery arising from the spinal dorsal branch of the segmental artery (posterior intercostal, subcostal, or lumbar artery), which in turn arises from the descending aorta.<ref>Template:Cite journal</ref> It typically arises from a 9th to 11th left posterior intercostal artery,<ref name="takase">Template:Cite journal</ref> enters through the L2-L3 intervertebral foramen to join the anterior spinal artery and supply much of the inferior half of the spinal cord.<ref name=":0">Template:Cite book</ref> The artery is named after pathologist Albert Wojciech Adamkiewicz.

Nomenclature

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

• great radicular artery of Adamkiewicz<ref name="pmid3228004">Template:Cite journal</ref>
• major anterior segmental medullary artery
• artery of the lumbar enlargement<ref name="pmid15814949">Template:Cite journal</ref>
• great anterior radiculomedullary artery<ref name="pmid16908582">Template:Cite journal</ref>
• great anterior segmental medullary artery<ref>Template:Cite journal</ref>
• great ventral radicular artery<ref name=":0" />

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.<ref>Template:Cite journal</ref> 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.<ref name=takase/>

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.<ref name="amato">Template:Cite journal</ref>

Clinical significance

The artery provides blood supply to the front two-thirds of the lumbar and sacral cord.<ref>Template:Cite bookTemplate:Page needed</ref> When damaged or obstructed, it can result in a syndrome of spinal cord ischemia, similar to anterior spinal artery syndrome,<ref>Template:Cite journal</ref> 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.<ref>Template:Cite journal</ref>

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.<ref name="LopezLee2006">Template:Cite journal</ref> Its location can be identified with computed tomographic angiography.<ref name="pmid17182250">Template:Cite journal</ref>

History

It is named for Albert Wojciech Adamkiewicz.<ref>Template:Cite journal</ref><ref>Template:WhoNamedIt</ref><ref name="pmid12382351">Template:Cite journal</ref>

External links

• Template:Chorus
• A video showing the Adamkiewicz artery can be seen here: AKA finding using OsiriX