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Master's Dissertation
DOI
https://doi.org/10.11606/D.17.2017.tde-07062017-151417
Document
Author
Full name
Flavio Porto Franco Piola
E-mail
Institute/School/College
Knowledge Area
Date of Defense
Published
Ribeirão Preto, 2017
Supervisor
Committee
Herrero, Carlos Fernando Pereira da Silva (President)
Barbosa, Marcello Henrique Nogueira
Oliveira, Valdeci Manoel de
Simão, Marcelo Novelino
Title in Portuguese
Avaliação da artéria de Adamkiewicz através da angiotomografia computadorizada coronariana de múltiplos detectores acoplado ao eletrocardiograma
Keywords in Portuguese
Angiotomografia computadorizada
Artéria de Adamkiewicz
Paraplegia
Vascularização da medula espinal
Abstract in Portuguese
A Artéria de Adamkiewicz é a maior artéria radiculomedular anterior que alcança a artéria espinal anterior, sendo responsável pelo suprimento sanguíneo de até dois terços distais da medula espinal. Uma lesão desta artéria durante um procedimento cirúrgico implica em graves complicações como paresia de membros inferiores e também paraplegia, muitas vezes de caráter definitivo, podendo acontecer durante a realização do tratamento cirúrgico de aneurismas toracoabdominais e patologias da coluna vertebral. Geralmente a artéria de Adamkiewicz está localizada entre a oitava vértebra torácica e a primeira lombar. Os exames de angiotomografia computadorizada da medula espinal e angioressonância magnética são métodos seguros, não invasivos e amplamente utilizados para identificá-la. Esta investigação teve como objetivo avaliar a Artéria de Adamkiewicz através da Angiotomografia Computadorizada Coronariana de Múltiplos Detectores acoplado ao Eletrocardiograma. Por meio de estudo prospectivo, foram analisados 86 exames de angiotomografia coronariana. Os exames foram analisados por dois investigadores independentes e a confiabilidade inter e intraobservador das variáveis nível de origem e lado de entrada foi avaliada. Os resultados evidenciaram uma taxa de identificação da artéria de Adamkiewicz em 71 (82,5%) exames. O nível de origem foi identificado entre T9 e T11 em 56 (79,2%) exames. Em relação ao lado, em 65 (91,5%) pacientes o lado de entrada foi o lado esquerdo. O exame de angiotomografia computadorizada coronariana de Múltiplos Detectores acoplado ao Eletrocardiograma mostrou taxas de identificação da artéria de Adamkiewicz semelhantes aos encontrados nos exames de angiografia, angiotomografia computadorizada e angioressonância da medula espinal
Title in English
Adamkiewicz artery evaluation by angiotomography coronary computed with multiple detectors coupled to electrocardiogram
Keywords in English
Adamkiewicz artery
CT angiography
Paraplegia
Spinal cord vascularization
Abstract in English
The Adamkiewicz artery is the most important radiculomedular artery that reaches the anterior spinal artery and is responsible for blood supply to distal two thirds of the spinal cord. An injury to this artery during a surgical procedure involves serious complications such as paresis of lower limbs and also paraplegia, often permanently, which may happen during the surgical treatment of thoracoabdominal aneurysms and pathologies of the spine. Usually the Adamkiewicz artery is located between the eighth thoracic vertebra and the first lumbar. Computed tomography angiography scans and spinal magnetic resonance angiography are safe methods, non-invasive and widely used to identify it. This research aimed to evaluate the artery of Adamkiewicz by Computed Coronary Tomography Angiography with multiple detectors coupled to Electrocardiogram. In a prospective study, we analyzed 86 exams of Computed Coronary Tomography Angiography. The exams were analyzed by two independent researchers and the inter and intraobserver reliability of the variables source level and entrance side was evaluated. The results showed an identification rate of Adamkiewicz artery in 71 (82.5%) examinations. The level of origin was identified between T9 and T11 in 56 (79.2%) examinations. In relation to the side, in 65 (91.5%) patients had the entrance side on the left side. Adamkiewicz artery evaluation by Angiotomography Coronary Computed with Multiple detectors coupled to Electrocardiogram showed Adamkiewicz artery identification rates similar to those found in angiography examinations, computadorized tomography angiography and magnetic resonance angiography of the spinal cord
 
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Publishing Date
2017-08-11
 
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