Value of MR angiography of Adamkiewicz artery as a preoperative investigation for thoracic-descending and thoracoabdominal aortic aneurysms. Retrospective study of 106 cases

We reviewed 106 cases who underwent MR angiography to visualize the Adamkiewicz artery (AKA) as a preoperative evaluation of the thoracic descending and thoracoabdominal aortic aneurysms. MR angiography depicted the AKA successfully in 68% of the patients. However, segmental artery that gives rise the AKA was occluded in 41% at its origin from the aorta. In one patient with postoperative paraplegia, broad infarction in the upper thoracic cord seems not to be related to the territory of the AKA that was visualized by MR angiography. Preoperative MR angiography serves planning of surgery, and can reduce time of aortic cross-clamping. However, our understanding of the value of MR angiography to prevent spinal cord ischemic injury requires further clinical investigation. (author)