eISSN: 2299-0054
ISSN: 1895-4588
Videosurgery and Other Miniinvasive Techniques
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1/2018
vol. 13
 
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abstract:
Case report

Ischaemia of the medullary cone after stent-graft implantation in a patient with abdominal aortic aneurysm – a case study

Mariusz Wachowski, Michał Polguj, Janusz Ścibór, Agata Majos

Videosurgery Miniinv 2018; 13 (1): 116–121
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Preoperative visualization of the Adamkiewicz artery – the vessel which is to a great extent responsible for supplying blood to the medullary cone – is an important step which must be taken before initiating restorative procedures in the aorta. We present a case of a 67-year-old patient who underwent an intravascular stent-graft implantation procedure, due to clinical signs of abdominal aortic aneurysm. Routine pre-operative computed tomography examination failed to demonstrate the Adamkiewicz artery. On the second day after the surgery, as a result of unexpected clinical deterioration, an magnetic resonance imaging examination of the lumbar spine was carried out. Based on the magnetic resonance imaging images and clinical manifestations the diagnosis of ischaemia of the medullary cone was made. In our work we also present a deep analysis of the anatomy of small-sized vessels supplying blood to the spinal cord and discuss effective techniques which enable visualization of the Adamkiewicz artery.
keywords:

aortic aneurysm, Adamkiewicz artery, spinal cord vascularization, medullary cone

  
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