Peer-Reviewed Journal Details
Mandatory Fields
Sultan, S,Hynes, N,Elsafty, N,Tawfick, W
Vascular And Endovascular Surgery
Eight Years Experience in the Management of Median Arcuate Ligament Syndrome by Decompression, Celiac Ganglion Sympathectomy, and Selective Revascularization
Optional Fields
median arcuate ligament syndrome celiac axis compression celiac ganglion hyperstimulation surgical decompression mesenteric revascularization ARTERY COMPRESSION SYNDROME CHRONIC MESENTERIC ISCHEMIA GASTRIC EXERCISE TONOMETRY CT ANGIOGRAPHY CASE SERIES DIAGNOSIS DISEASE THERAPY RELEASE FLOW
We aim to review an 8-year experience of median arcuate ligament syndrome (MALS) with chronic gastrointestinal ischemia (CGI) and evaluate clinical outcomes of arcuate ligament decompression, celiac sympathectomy, and selective revascularization. Between December 2002 and March 2012, of 25 patients referred with symptoms of CGI, 11 patients (10 women and 1 man) had clinical signs of abdominal angina and radiological evidence of MALS. Mean age was 50 +/- 20.4 years. Median symptom duration was 34 months. All patients had median arcuate decompression and celiac sympathectomy. In all, 8 did not require revascularization, 2 had retrograde celiac and/or superior mesenteric artery (SMA) stenting, and 1 had SMA bypass. There was no mortality. The 30-day morbidity was 9%. Mean follow-up was 60 months. Eight patients noted complete relief of abdominal pain, and 1 reported some improvement. The MALS is not solely a vascular compression syndrome. The neurological component requires careful celiac plexus sympathectomy in addition to arcuate ligament decompression.
DOI 10.1177/1538574413500536
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