Vascular Anatomy Related to the Intervertebral Disc
Peter Ghosh in The Biology of the Intervertebral Disc, 2019
The intraosseous distribution of these main branches of the lumbar arteries is as follows: (1) the centrum branches form an arterial grid in the middle of the vertebral body, from which branches pass upwards and downwards to end in arterioles which are oriented vertically at right angles to the middle third of the respective vertebral end-plates (Figures 7 and 10); (2) ascending branches and (3) descending branches penetrate the anterolateral aspects of the vertebral body somewhat obliquely towards its center, dropping vertically oriented arteriolar branches towards their related vertebral end-plates in the outer thirds of the vertebra (Figures 10 and 11); and (4) the anterior spinal canal branches form an arterial arcade on the posterior surface of the vertebral bodies as described above (Figure 9). From this system, intraosseous branches analogous to those from the centrum and ascending and descending branches of the lumbar arteries on the anterolateral aspects of the vertebral body penetrate the body from behind (Figure 11).
Peripheral Vessel Doppler
Swati Goyal in Essentials of Abdomino-Pelvic Sonography, 2018
Abdominal aorta and its branches. Celiac artery—L1 level.Superior mesenteric artery—1 centimeter below celiac axis.Renal arteries—Bilateral.Inferior mesenteric artery.Middle sacral artery.Lumbar arteries—Minor branches.Aorta bifurcates into two common iliac arteries, which further branches into external and internal arteries bilaterally.External iliac branches into inferior epigastric and the deep circumflex iliac artery continues as the femoral artery.Branches of femoral artery—Common femoral artery gives profunda femoris branch and continues as superficial femoral artery, which further continues as the popliteal artery.
Open Nonruptured Infrarenal Aortic Aneurysm Repair
Sachinder Singh Hans, Alexander D Shepard, Mitchell R Weaver, Paul G Bove, Graham W Long in Endovascular and Open Vascular Reconstruction, 2017
Following definition of the neck of the aneurysm, dissection anterior and posterior to the aorta establishes a plane for placement of a cross-clamp; no attempt is made to dissect the aorta circumferentially as long as the clamp arms can pass beyond its far wall. The vena cava is not immediately adjacent to the aorta at this level, so caval injury is not a concern. When suprarenal aortic control is necessary, dissection proceeds cephalad along the aorta toward the left diaphragmatic crus, which is identified as a firm tendinous band crossing the aorta just proximal to the origin of the LRA. The crural fibers are divided 2-3 cm along the axis of the aorta and the underlying aortic wall is exposed. The origin of the LRA is cleared off and finger dissection anterior and posterior to the aorta creates a plane for clamp placement. A pair of lumbar arteries at this level should be carefully watched for and avoided. For supraceliac aortic control, the crural fibers are divided an additional 5 cm and the fascia investing the aorta is incised to allow fingertip dissection anterior and posterior to the aorta. Supraceliac aortic control is in fact easier to obtain with this approach than is suprarenal aortic control because of the relative absence of retroperitoneal fat and lymphatics at this level. When anticipating the need for supraceliac aortic control preoperatively, access can be improved by a 10th ICS incision.
Paraplegia following transarterial chemoembolisation for hepatocellular carcinoma: a case report
Published in Acta Chirurgica Belgica, 2021
The risk of spinal cord injury associated with ICA intervention exists because the spinal cord artery originates from the proximal ICA. The spinal cord is supplied primarily by one anterior and two posterior spinal arteries, which are augmented by radicular arteries derived from spinal branches of cervical, intercostal, and lumbar arteries [9]. The anterior spinal artery (ASA) supplies blood to the anterior two-thirds of the cord, including the anterior horns of the grey matter, spinothalamic tracts, and corticospinal tracts, which primarily dominate the motor nuclei. The two posterior spinal arteries (PSA) supply the dorsal columns and the posterior horns, which mainly process sensory information [10]. Therefore, because of anatomy and neurological distribution, the embolic materials created as part of TACE may bring about an embolic event with possible serious manifestations, even though the blood supply network of the spinal cord encompasses multiple anastomoses.
The impact of type 1a endoleak on the long-term outcome after EVAR
Published in Acta Chirurgica Belgica, 2021
Jan Van Slambrouck, Hozan Mufty, Geert Maleux, Sabrina Houthoofd, Anne Devooght, Charlotte Slots, Kim Daenens, Inge Fourneau
In nine patients (64.3%), reintervention with the placement of an aortic cuff was performed. In one patient it was combined with the placement of a Palmaz stent and in another patient, it was combined with endo stapling. In one case, placement of the aortic cuff did not resolve the type 1a endoleak that was visualised on the next follow-up CTA. Subsequent efforts to perform transarterial embolisation of the endoleak also failed. Another one of the nine patients initially suffered from a type 3 endoleak that was treated with an endovascular relining four years after EVAR. Sixteen years after EVAR a proximal type 1 endoleak occurred that was successfully treated with an aortic cuff. In two cases (14.3%), transarterial coil and glue embolisation of the proximal attachment site was used to resolve the type 1a endoleak. Open wrapping and ligation of the lumbar arteries were done in one of these patients because of continuous growth.
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.
Related Knowledge Centers
- Aorta
- Inferior Vena Cava
- Intercostal Arteries
- Lumbar Vertebrae
- Sympathetic Trunk
- Vertebra
- Artery
- Lumbar
- Median Sacral Artery
- Crus of Diaphragm