Case: 52 year old male is admitted to ICU with massive hemoptysis. The patient was intubated and send to interventional radiology for bronchial artery embolization, which was successfully done. On arrival to ICU plan was made to extubate the patient. As sedation was weaned off, the patient was found to have an impaired motor function of the legs.
Explanation: During bronchial artery embolization inadvertent occlusion of the artery of Adamkiewicz may occur. Artery of Adamkiewicz is the major blood supply to the lumbar and sacral cord. Its obstruction may result in the impaired motor function of the legs. In the majority of patients, the artery of Adamkiewicz contributes to the anterior spinal artery between the T9 to T12 level.
1. Lopez, January; Lee, Hsin-Yi. "Bronchial Artery Embolization for Treatment of Life-Threatening Hemoptysis". Seminars in Interventional Radiology. 2006: 23 (3): 223–229.
2. Hurst RW. Spinal vascular disorders. In: Resonance Imaging of the Brain and Spine, 2nd ed, Atlas SW (Ed), Lippincott, Philadelphia 2006. p.1387.