Clinical significance of mesenteric arterial collateral circulation in patients with celiac artery compression syndrome
Open accessAbstract
Objective Although extensive collateral arterial circulation will prevent ischemia in most patients with stenosis of a single mesenteric artery, mesenteric ischemia may occur in these patients, for example, in patients with celiac artery compression syndrome (CACS). Variation in the extent of collateral circulation may explain the difference in clinical symptoms and variability in response to therapy; however, evidence is lacking. The objective of the study was to classify the presence of mesenteric arterial collateral circulation in patients with CACS and to evaluate the relation with clinical improvement after treatment. Methods Collateral mesenteric circulation was classified on the basis of angiographic findings. Collaterals were categorized in three groups: no visible collaterals (grade 0), collaterals seen on selective angiography only (grade 1), and collaterals visible on nonselective angiography (grade 2). Surgical release of the celiac artery in patients with suspected CACS was performed by arcuate ligament release. Clinical success after surgical revascularization was defined as an improvement in abdominal pain. Results Between 2002 and 2013, there were 135 consecutive patients with suspected CACS who were operated on. In 129 patients, preoperative angiograms allowed classification of collateral circulation. Primary assisted anatomic success was 93% (120/129). In patients with grade 0 collaterals, clinical success was 81% (39 of 48 patients); with grade 1 collaterals, 89% (25 of 28 patients); and with grade 2 collaterals, 52% (23 of 44 patients; P < .001). Conclusions Patients with CACS and with extensive collateral mesenteric arterial circulation are less likely to benefit from arcuate ligament release than are patients without this type of collateral circulation. The classification of the extent of mesenteric collateral circulation may predict and guide shared decision-making in patients with CACS.
Integrity signals
Registry
Cites
Statistics
Claims the paper makes
Claims other papers make about this one
Each is checked against this paper’s own text: does it say what the citing paper says it does?
Patients with MALS with mesenteric collateral arterial circulation (at least one collateral clearly visible on non-selective DSA) were less likely to benefit from CA release than patients without an extensive collateral circulation.
“However, patients with MALS with mesenteric collateral arterial circulation (at least one collateral clearly visible on non-selective DSA) were less likely to benefit from CA release than patients without an extensive collateral circulation.”
Cites
Exercise Training for Claudication
Stewart, K. J., Hiatt, W. R., Regensteiner, J. G., & Hirsch, A. T. (2002) · New England Journal of Medicine · doi:10.1056/nejmra021135 · Cited by 536 · see citing works
Blood Supply and Anatomy of the Upper Abdominal Organs with a Descriptive Atlas
Michels, N. A. (1958) · JAMA · doi:10.1001/jama.1958.02990060146035 · Cited by 392 · see citing works
Schaper, W. K. A. (2008) · Basic Research in Cardiology · doi:10.1007/s00395-008-0760-x · Cited by 388 · see citing works
Mesenteric duplex scanning: A blinded prospective study
Moneta, G. L., Lee, R. W., Yeager, R. A., Taylor, L. M., & Porter, J. M. (1993) · Journal of Vascular Surgery · doi:10.1016/0741-5214(93)90011-a · Cited by 283 · see citing works
Open and laparoscopic treatment of median arcuate ligament syndrome
Jimenez, J. C., Harlander-Locke, M., & Dutson, E. P. (2012) · Journal of Vascular Surgery · doi:10.1016/j.jvs.2012.04.057 · Cited by 248 · see citing works
Zhang, H., Prabhakar, P., Sealock, R. W., & Faber, J. E. (2010) · Journal of Cerebral Blood Flow & Metabolism · doi:10.1038/jcbfm.2010.10 · Cited by 244 · see citing works
Exercise Training in Coronary Artery Disease and Coronary Vasomotion
Gielen, S., Schuler, G. C., & Hambrecht, R. (2001) · Circulation · doi:10.1161/01.cir.103.1.e1 · Cited by 231 · see citing works
Ischemic disorders of the intestines
Boley, S. J., Brandt, L. J., & Veith, F. J. (1978) · Current Problems in Surgery · doi:10.1016/s0011-3840(78)80018-5 · Cited by 201 · see citing works
The celiac artery compression syndrome: does it exist?
Szilagyi, D. E., Rian, R. L., Elliott, J. P., & Smith, R. F. (1972) · PubMed · Cited by 178 · see citing works
Mensink, P. B. F., van Petersen, A. S., Kolkman, J. J., Otte, J. A., Huisman, A. B., & Geelkerken, R. H. (2006) · Journal of Vascular Surgery · doi:10.1016/j.jvs.2006.03.038 · Cited by 143 · see citing works
Self-citationWall Remodeling During Luminal Expansion of Mesenteric Arterial Collaterals in the Rat
Unthank, J. L., Fath, S. W., Burkhart, H. M., Miller, S. C., & Dalsing, M. C. (1996) · Circulation Research · doi:10.1161/01.res.79.5.1015 · Cited by 126 · see citing works
Median arcuate ligament syndrome: vascular surgical therapy and follow-up of 18 patients
Grotemeyer, D., Duran, M., Iskandar, F., Blondin, D., Nguyen, K., & Sandmann, W. (2009) · Langenbeck s Archives of Surgery · doi:10.1007/s00423-009-0509-5 · Cited by 119 · see citing works
Mesenteric/celiac duplex ultrasound interpretation criteria revisited
AbuRahma, A. F., Stone, P. A., Srivastava, M., Dean, L. S., Keiffer, T., Hass, S. M., & Mousa, A. Y. (2011) · Journal of Vascular Surgery · doi:10.1016/j.jvs.2011.08.052 · Cited by 117 · see citing works
Longland, C. J. (1953) · PubMed Central · Cited by 114 · see citing works
Mesenteric Vasculature and Collateral Pathways
Walker, T. (2009) · Seminars in Interventional Radiology · doi:10.1055/s-0029-1225663 · Cited by 109 · see citing works
Clinical significance of splanchnic artery stenosis
Mensink, P. B. F., van Petersen, A. S., Geelkerken, R. H., Otte, J. A., Huisman, A. B., & Kolkman, J. J. (2006) · British Journal of Surgery · doi:10.1002/bjs.5481 · Cited by 107 · see citing works
Self-citationAnatomy of the Splanchnic Circulation
Kornblith, P. L., Boley, S. J., & Whitehouse, B. S. (1992) · Surgical Clinics of North America · doi:10.1016/s0039-6109(16)45625-2 · Cited by 105 · see citing works
Retroperitoneal endoscopic release in the management of celiac artery compression syndrome
van Petersen, A. S., Vriens, B. H. R., Huisman, A. B., Kolkman, J. J., & Geelkerken, R. H. (2009) · Journal of Vascular Surgery · doi:10.1016/j.jvs.2008.12.077 · Cited by 92 · see citing works
Self-citationOtte, J. A., Geelkerken, R. H., Oostveen, E., Mensink, P. B. F., Huisman, A. B., & Kolkman, J. J. (2005) · Clinical Gastroenterology and Hepatology · doi:10.1016/s1542-3565(05)00155-2 · Cited by 88 · see citing works
Self-citationMesenteric stenosis, collaterals, and compensatory blood flow
van Petersen, A. S., Kolkman, J. J., Meerwaldt, R., Huisman, A. B., van der Palen, J., Zeebregts, C. J., & Geelkerken, R. H. (2014) · Journal of Vascular Surgery · doi:10.1016/j.jvs.2014.01.063 · Cited by 87 · see citing works
Self-citationRegulation of collateral blood vessel development by the innate and adaptive immune system
Sala, A., Pontecorvo, L., Agresta, A., Rosano, G. M. C., & Stabile, E. (2012) · Trends in Molecular Medicine · doi:10.1016/j.molmed.2012.06.007 · Cited by 77 · see citing works
Aschenbach, R., Basche, S., & Vogl, T. J. (2011) · Journal of Vascular and Interventional Radiology · doi:10.1016/j.jvir.2010.11.007 · Cited by 69 · see citing works
Early collateral and microvascular adaptations to intestinal artery occlusion in rat
Unthank, J. L., Nixon, J. C., Burkhart, H. M., Fath, S. W., & Dalsing, M. C. (1996) · American Journal of Physiology-Heart and Circulatory Physiology · doi:10.1152/ajpheart.1996.271.3.h914 · Cited by 60 · see citing works
Unthank, J. L., Nixon, J. C., & Lash, J. M. (1995) · Journal of Applied Physiology · doi:10.1152/jappl.1995.79.1.73 · Cited by 48 · see citing works
Bérard, X., Cau, J., Déglise, S., Trombert, D., Saint-Lèbes, B., Midy, D., Corpataux, J.-M., & Ricco, J. (2011) · European Journal of Vascular and Endovascular Surgery · doi:10.1016/j.ejvs.2011.09.023 · Cited by 47 · see citing works
Celiac and superior mesenteric arteries : a correlation of angiograms and dissections
Nebesar, R. A., & Russell, P. S. (1969) · Churchill eBooks · Cited by 43 · see citing works
van Petersen, A. S., Meerwaldt, R., Kolkman, J. J., Huisman, A. B., van der Palen, J., van Bockel, J. H., Zeebregts, C. J., & Geelkerken, R. H. (2013) · Journal of Vascular Surgery · doi:10.1016/j.jvs.2012.11.120 · Cited by 37 · cited 1× · see citing works
“Angiography was performed during maximum expiration and inspiration phases of respiration, as described previously.(13) For nonselective angiography, a pigtail catheter was placed in the aorta 3 to 4 cm above the CA ostium, and a standard bolus of 25 mL of contrast material was given with a pump flow of 15 mL/s.”
MethodSelf-citationCeliac artery compression syndrome: a radiological finding without clinical symptoms?
Kazan, V. M., Qu, W., Al-Natour, M. S., Abbas, J. T., & Nazzal, M. (2013) · Vascular · doi:10.1177/1708538113478750 · Cited by 35 · see citing works
Celiac and Superior Mesenteric Arteries: A Correlation of Angiograms and Dissections
Cooper, P. R., & McElhinney, A. J. (1970) · The Annals of Thoracic Surgery · doi:10.1016/s0003-4975(10)65401-x · Cited by 35 · see citing works
Libicher, M., Reichert, V., Aleksic, M., Brunkwall, J. S., Lackner, K. J., & Gawenda, M. (2008) · European Journal of Vascular and Endovascular Surgery · doi:10.1016/j.ejvs.2008.04.009 · Cited by 34 · see citing works
Wall Remodeling after Wall Shear Rate Normalization in Rat Mesenteric Arterial Collaterals
Fath, S. W., Burkhart, H. M., Miller, S. C., Dalsing, M. C., & Unthank, J. L. (1998) · Journal of Vascular Research · doi:10.1159/000025592 · Cited by 28 · see citing works
Collateral Growth in the Peripheral Circulation: A Review
Unthank, J. L., Sheridan, K. M., & Dalsing, M. C. (2004) · Vascular and Endovascular Surgery · doi:10.1177/153857440403800401 · Cited by 25 · see citing works
Doppler waveforms of the normal and collateralized inferior mesenteric artery.
Erden, A., Yurdakul, M., & Cumhur, T. (1998) · American Journal of Roentgenology · doi:10.2214/ajr.171.3.9725285 · Cited by 23 · see citing works
The arterial vascularization of the large intestine. Anatomical and radiological study.
Bertelli, L., Lorenzini, L., & Bertelli, E. (1996) · PubMed · Cited by 18 · see citing works
Flagged first, then by citations
1 of the 35 references couldn’t be matched to a known paper.
Cited by
Sorted by citations
Median arcuate ligament syndrome
Goodall, R. J., Langridge, B., Onida, S., Ellis, M. R., Lane, T. R. A., & Davies, A. H. (2019) · Journal of Vascular Surgery · doi:10.1016/j.jvs.2019.11.012 · Cited by 178 · see citing works
Koelemay, M. J., Geelkerken, R. H., Kärkkäinen, J., Leone, N., Antoniou, G. A., de Bruin, J. L., Gombert, A., Gottsätter, A., Iborra, E., Ronchey, S., et al. (2025) · European Journal of Vascular and Endovascular Surgery · doi:10.1016/j.ejvs.2025.06.010 · Cited by 123 · see citing works
Self-citationDiagnosis and treatment of chronic mesenteric ischemia: An update
Kolkman, J. J., & Geelkerken, R. H. (2017) · Best Practice & Research Clinical Gastroenterology · doi:10.1016/j.bpg.2017.01.003 · Cited by 92 · see citing works
Self-citationPostural tachycardia syndrome: current perspectives
Wells, R. M., Spurrier, A. J., Linz, D., Gallagher, C., Mahajan, R., Sanders, P., Page, A. J., & Lau, D. H. (2017) · Vascular Health and Risk Management · doi:10.2147/vhrm.s127393 · Cited by 69 · see citing works
Systematic Review of the Efficacy of Treatment for Median Arcuate Ligament Syndrome
Metz, F. M., Blauw, J. T. M., Brusse-Keizer, M., Kolkman, J. J., Bruno, M. J., & Geelkerken, R. H. (2022) · European Journal of Vascular and Endovascular Surgery · doi:10.1016/j.ejvs.2022.08.033 · Cited by 44 · see citing works
Self-citationChaum, M., Shouhed, D., Kim, S., Walts, A. E., & Marchevsky, A. M. (2021) · Annals of Diagnostic Pathology · doi:10.1016/j.anndiagpath.2021.151732 · Cited by 38 · see citing works
The Laparoscopic Management of Median Arcuate Ligament Syndrome and Its Long-Term Outcomes
De’Ath, H. D., Wong, S., Szentpáli, K., Somers, S. S., Peck, T. E., & Wakefield, C. H. (2018) · Journal of Laparoendoscopic & Advanced Surgical Techniques · doi:10.1089/lap.2018.0204 · Cited by 36 · see citing works
Vascular imaging of the mesenteric vasculature
van Dijk, L. J. D., van Petersen, A. S., & Moelker, A. (2017) · Best Practice & Research Clinical Gastroenterology · doi:10.1016/j.bpg.2016.12.001 · Cited by 30 · see citing works
Self-citationACR Appropriateness Criteria® radiologic management of mesenteric ischemia: 2022 update
Lam, A., Kim, Y.-J., Fidelman, N., Higgins, M., Cash, B. D., Charalel, R. A., Guimaraes, M. S., Kwan, S. W., Patel, P. J., Plett, S., et al. (2022) · Journal of the American College of Radiology · doi:10.1016/j.jacr.2022.09.006 · Cited by 29 · see citing works
Functional testing in the diagnosis of chronic mesenteric ischemia
van Noord, D., & Kolkman, J. J. (2017) · Best Practice & Research Clinical Gastroenterology · doi:10.1016/j.bpg.2016.12.002 · Cited by 26 · see citing works
Self-citationMezzetto, L., Mastrorilli, D., Bravo, G., Scorsone, L., Gennai, S., Leone, N., D’Oria, M., Veraldi, E., & Veraldi, G. F. (2022) · Journal of Endovascular Therapy · doi:10.1177/15266028221090443 · Cited by 10 · see citing works
Giakoustidis, A. E., Moschonas, S., Christodoulidis, G., Chourmouzi, D., Diamantidou, A., Masoura, S., Louri, E., Papadopoulos, V. N., & Giakoustidis, D. E. (2023) · World Journal of Gastrointestinal Surgery · doi:10.4240/wjgs.v15.i6.1048 · Cited by 10 · see citing works
Minagawa, M., Ichida, H., Yoshioka, R., Gyoda, Y., Mizuno, T., Imamura, H., Mise, Y., Yoshimatsu, H., Fukumura, Y., Kato, K., et al. (2020) · Surgical Case Reports · doi:10.1186/s40792-020-01019-0 · Cited by 9 · see citing works
Collateral circulation develops in stenosis of the celiac trunk and superior mesenteric artery
Salım, H., Özgür, Ö., Erman, K., Öztürk, S., Dogan, M., Sindel, T., & Sındel, M. (2023) · Surgical and Radiologic Anatomy · doi:10.1007/s00276-023-03104-z · Cited by 8 · see citing works
Endovascular Pressure Measurements to Assess the Functional Severity of Mesenteric Arterial Stenoses
van Dijk, L. J. D., Terlouw, L. G., van Noord, D., Bijdevaate, D. C., Bruno, M. J., & Moelker, A. (2020) · Journal of Vascular and Interventional Radiology · doi:10.1016/j.jvir.2019.10.019 · Cited by 7 · see citing works
Self-citationDevelopment of a Novel Scoring Model to Estimate the Severity Grade of Mesenteric Artery Stenosis
Omran, S., Konietschke, F., Mueller, V., de Bucourt, M., Frese, J. P., & Greiner, A. (2022) · Journal of Clinical Medicine · doi:10.3390/jcm11247420 · Cited by 6 · see citing works
Ito, K., Takemura, N., Inagaki, F. F., Mihara, F., Shida, Y., Tajima, T., & Kokudo, N. (2020) · Clinical Anatomy · doi:10.1002/ca.23716 · Cited by 6 · see citing works
Lanka, S. P., Hakaim, A. G., Bowers, S. P., Erben, Y., Bruce, B. K., Cangemi, D. J., Stone, W. M., Paz‐Fumagalli, R., Ritchie, C. A., Gloviczki, P., et al. (2024) · Annals of Vascular Surgery · doi:10.1016/j.avsg.2024.08.010 · Cited by 5 · see citing works
Unusual variations in the branching pattern of the coeliac trunk and their clinical significance
Juszczak, A., Czyżowski, J., Mazurek, A., Walocha, J. A., & Pasternak, A. (2020) · Folia Morphologica · doi:10.5603/fm.a2020.0067 · Cited by 5 · see citing works
Abdallah, I. B., Cerceau, P., Pellenc, Q., Huguet, A., Corcos, O., & Castier, Y. (2019) · Annals of Vascular Surgery · doi:10.1016/j.avsg.2019.01.009 · Cited by 4 · see citing works
Xu, L., Wu, Y., Zhang, J., Zhang, X., Bai, X., Chen, L., Peng, Q., Guo, E., Zhang, G., Jin, Z., et al. (2024) · European Journal of Radiology · doi:10.1016/j.ejrad.2024.111805 · Cited by 4 · see citing works
Oikawa, R., Ito, K., Takemura, N., Mihara, F., & Kokudo, N. (2020) · Surgical Case Reports · doi:10.1186/s40792-020-0787-2 · Cited by 4 · see citing works
Sui, H., Yan, C., Yang, J., & Zhao, X. (2021) · Advances in Clinical and Experimental Medicine · doi:10.17219/acem/121927 · Cited by 2 · see citing works
Sarmiento-Falen, J., Erben, Y., Alsabbagh, Y., Jlilati, A., Jacobs, C., Elli, E. F., & Farres, H. (2026) · European Journal of Vascular and Endovascular Surgery · doi:10.1016/j.ejvs.2026.06.046 · Cited by 1 · see citing works
Dunbar syndrome as a cause of chronic abdominal pain in a 24-year-old female
Koenig, Z. A., & Yednock, J. B. (2020) · Case Reports in Internal Medicine · doi:10.5430/crim.v7n1p15
Isquemia mesentérica: manejo endovascular
Hernán, A. S. T. E., Napoleón Delgado, S., Pilar Cabrera, M., Juan Carlos Del Hierro, C., Luis Bracamonte, O., & Akira Tsuha, A. (2021) · Revista Médica Herediana · doi:10.20453/rmh.v32i2.3987
Blauw, J. T. M. (2021) · doi:10.3990/1.9789036553278
Self-citationA case report on median arcuate ligament syndrome: Need for a high index of suspicion
Chaudhary, G., Grewal, D. S., Maheshwari, S., Amaravadi, S., & Khadka, A. (2022) · Medicine India · doi:10.25259/medindia_9_2021
Geelkerken, R. H., Blauw, J. T. M., & van Noord, D. (2021) · Bohn Stafleu van Loghum eBooks · doi:10.1007/978-90-368-2518-4_26
Self-citationAday, U., Oğuz, A., Özesmer, H., & Bahadır, M. V. (2023) · PubMed Central · doi:10.22088/cjim.14.2.396
Fay, K. T., & Patel, A. D. (2025) · Springer eBooks · doi:10.1007/978-3-031-80740-4_5
Haruta, H., Higashida, M., Hoshina, K., Takayama, T., Ueno, T., Chiba, S., Ideno, N., Ikenaga, N., Endo, S., Sakuma, Y., et al. (2025) · Asian Journal of Endoscopic Surgery · doi:10.1111/ases.70208
Median arcuate ligament syndrome without weight loss: A challenging diagnosis
Awan, M., & Kashbour, M. O. (2026) · South African Journal of Surgery · doi:10.36303/sajs.03308
Case Report: Recurrent peptic ulcer perforations—a possible role of median arcuate ligament syndrome
Milotić, M., Milotić, L., Lekić, V., Bazdulj, E., Radolović, R., Fabris, L. K., & Kvolik, S. (2026) · Frontiers in Surgery · doi:10.3389/fsurg.2026.1908665
- Authors
- van Petersen, A. S., Kolkman, J. J., Gerrits, D. G., van der Palen, J., Zeebregts, C. J., Geelkerken, R. H., Bruno, M. J., van Dijk, L. J. D., Moelker, A., Peppelenbosch, M. P., Verhagen, H. J. M., Blauw, J. T. M., Geelkerken, R. H., Kolkman, J. J., van Petersen, A. S., & Bakker, O. J.
- Affiliations
- Medisch Spectrum Twente (NL)
- University Medical Center Groningen (NL)
- ORCID
- Venue
- Journal of Vascular Surgery
- Publisher
- Elsevier BV
- Published
- 2017-05
- Volume
- 65
- Issue
- 5
- Pages
- 1366-1374
- ISSN
- 0741-5214 (ISSN-L)
- OpenAlex
- W2594924431
- Cited by
- 34
- References
- 35
- Citations by year
- 2026: 3 · 2025: 3 · 2024: 2 · 2023: 3 · 2022: 5 · 2021: 5 · 2020: 6 · 2019: 2 · 2018: 1 · 2017: 4
- FWCI
- 3.65
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Licence
- Locations
- Journal of Vascular Surgery (publishedVersion)
- PubMed (publishedVersion)
- Amsterdam UMC (VU Amsterdam) - Institutional Repository (publishedVersion)
- EUR Research Repository (Erasmus University Rotterdam) (publishedVersion)
- University of Groningen research database (University of Groningen / Centre for Information Technology) (publishedVersion, other-oa)
- University of Twente Research Information (publishedVersion)
- EUR Research Repository (Erasmus University Rotterdam) (submittedVersion)
- Pure Amsterdam UMC (submittedVersion)
- University of Groningen research database (University of Groningen / Centre for Information Technology) (submittedVersion, other-oa)
- University of Twente Research Information (submittedVersion)
- Data Archiving and Networked Services (DANS) (submittedVersion)
- Topics
- Health Sciences › Medicine › Surgery › Abdominal vascular conditions and treatments
- Health Sciences › Medicine › Surgery › Vascular anomalies and interventions
- Health Sciences › Medicine › Pulmonary and Respiratory Medicine › Renal and Vascular Pathologies
- Keywords
- celiac artery compression, mesenteric ischemia, celiac artery stenosis, preoperative angiography, abdominal pain, shared decision-making
- MeSH terms
- Median Arcuate Ligament Syndrome, Adolescent, Adult, Aged, Angioplasty, Balloon, Celiac Artery, Collateral Circulation, Constriction, Pathologic, Female, Humans, Male, Mesenteric Arteries, Middle Aged, Netherlands, Retrospective Studies, Splanchnic Circulation, Time Factors, Abdominal Pain, Angiography, Digital Subtraction, Databases, Factual, Treatment Outcome, Ultrasonography, Doppler, Duplex, Kaplan-Meier Estimate, Young Adult
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
Are you an author, or do you see a problem with this page? Request a review
