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Vascular Anatomy Related to the Intervertebral Disc
Published in Peter Ghosh, The Biology of the Intervertebral Disc, 2019
Henry V. Crock, Miron Goldwasser, Hidezo Yoshizawa
As each lumbar artery crosses its related intervertebral foramen, three sets of branches enter the spinal canal. Of these, the anterior spinal canal branches are relevant to the arterial supply of the vertebral body. They form an arcade on the posterior surfaces of the vertebral bodies from which the centrum and metaphyseal branches pass into the vertebral bodies (Figure 9).7
Open ruptured abdominal aortic aneurysm repair
Published in Sachinder Singh Hans, Alexander D Shepard, Mitchell R Weaver, Paul G Bove, Graham W Long, Endovascular and Open Vascular Reconstruction, 2017
After ensuring adequate volume resuscitation and proximal and distal occlusion, the anterior wall of the aneurysm sac is opened to the right of the IMA origin with electrocautery and scissors and the intraluminal thrombus is removed. Lumbar arteries are carefully controlled by figure-of-eight 2-0 silk suture. Because of heavy calcified plaque, local endarterectomy of the origin of the lumbar artery may be necessary to achieve hemostasis. The infrarenal/juxtarenal aorta is prepared for proximal anastomosis by dividing the aorta wall. A transverse incision distal to the origins of the renal arteries is made and joins the longitudinal aortotomy incision in a “T”-shaped manner. After lateral division of the aortic neck, the posterior wall of the aortic neck is divided a few millimeters longer than the anterior wall. Sometimes, the posterior wall of the aortic neck is not divided and is used as a double layer for proximal anastomosis. In most patients with RAAAs, an aorto-bi-iliac graft (18 X 9 mm or 20 x 10 mm) is required. In some situations, a straight tube graft may be quite appropriate if the distal abdominal aorta above the origin of the iliac arteries is of suitable quality. A tube graft in a patient with suitable anatomy decreases operative time, fluid requirements, and postoperative ileus. Rarely, an aortounifemoral or aortobifemoral graft is necessary. The author prefers knitted Dacron grafts.
The Bladder (BL)
Published in Narda G. Robinson, Interactive Medical Acupuncture Anatomy, 2016
2nd lumbar artery: One of four or five pairs of arteries that originate in the abdominal aorta and supply the lumbar vertebrae and the back muscles and abdominal wall. On occasion, one of the lumbar arteries provides the gonadal artery. The lumbar arteries supply part of the spinal cord, the vertebral body, and vertebral end plate. The lumbar arteries anastomose with the lower intercostal, the subcostal, the iliolumbar, the deep iliac circumflex, and the inferior epigastric arteries.
Outcomes of descending and thoracoabdominal aortic repair in connective tissue disorder patients
Published in Scandinavian Cardiovascular Journal, 2022
Magnus Jonsson, Linus Blohmé, Alireza Daryapeyma, Anders Günther, Göran Lundberg, Lena Nilsson, Carl-Magnus Wahlgren, Anders Franco-Cereceda, Christian Olsson
Overall, 128 branch arteries (36 renal, 19 coeliac trunk, 19 superior mesenteric arteries, 1 inferior mesenteric artery, 53 intercostal or lumbar artery) were revascularized, i.e. reimplanted to the main graft either as part of a patch (8/19, 42%) or anastomosed individually or through a side-branch (11/19, 58%). Renal arteries were revascularized in 18/19 TAAA repairs, in one a beveled distal anastomosis was used. For renal arteries, coeliac trunk, and superior and inferior mesenteric arteries, 100% of targets were revascularized and the primary success rate was 74/75 (99%); one left renal artery side-branch anastomosis was revised. Intercostal arteries were reimplanted in 3/7 DTAA (all targets) and 14/19 TAAA (14/17 targets, 82%) repairs and in one case an already occluded lumbar artery was reopened and reimplanted to counteract intraoperative signs of spinal cord ischemia. All patients had a radiological follow-up with CT and/or MRI (range, 1–11 studies). One side-arm branch to an intercostal artery pair was occluded without clinical consequences, all other branches remained patent.
A fatal and unusual iatrogenic fourth right lumbar artery injury complicating wrong-level hemilaminectomy: a case report and literature review
Published in British Journal of Neurosurgery, 2019
Francesco Ventura, Rosario Barranco, Carlo Bernabei, Lara Castelletti, Lucio Castellan
Not until the very end of the intervention did any symptoms of blood loss become evident, inasmuch as the extravasation mainly concerned the retroperitoneum and the peritoneal cavity, leaving the surgical field relatively free of blood. Furthermore, the fourth right lumbar artery, which is a small-caliber artery, produced a loss of blood at a rate particularly difficult to perceive throughout the surgical procedure. Therefore, in this case, the vascular lesion was suspected only when the patient began showing signs of worsening hypotension. However, the sudden onset of hemorrhagic shock rendered vain every attempt at pharmacological treatment and the patient succumbed prior to emergency surgical exploration.
Iliopsoas hematomas in people with hemophilia: diagnosis and treatment
Published in Expert Review of Hematology, 2020
E. Carlos Rodriguez-Merchan, Hortensia De la Corte-Rodriguez
In 1984, Peters et al. published the case of a 62-year-old patient with hemophilia with a large iliopsoas hematoma after minor trauma, confirmed by means of a CT scan. Intraperitoneal bleeding was also encountered. Angiography showed the bleeding had originated in the fourth right lumbar artery [21]. In 1985, Domula et al. analyzed 12 children with hemophilia (age range: 9–15 years) with iliopsoas hematomas. Only one patient needed surgery. In the rest of the children, hematological management using FVIII/FIX high-dose replacement therapy resulted in complete recuperation in 3 weeks [5].