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Cited by 31Abdominal vascular conditions and treatmentsVascular anomalies and interventionsRenal and Vascular Pathologies

The DOI matches its Crossref record; 25 of the 25 references it cites were found in a registry or an index.

Inability of conventional imaging findings to predict response to laparoscopic release of the median arcuate ligament in patients with celiac artery compression

Open access
Patel, Mikin V., Dalag, Leonard, Weiner, Alyssa, Skelly, Christopher, Lorenz, Jonathan·2019·Journal of Vascular Surgery
DOI 10.1016/j.jvs.2018.04.062
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Abstract

Objective The objective of this study was to identify duplex ultrasound (DUS) or computed tomography angiography (CTA) imaging findings that can predict clinical response to laparoscopic release of the median arcuate ligament (MAL) in patients with celiac artery compression. Methods There were 299 patients who were evaluated for MAL syndrome (MALS) between January 2009 and November 2015. Of these, 29 underwent laparoscopic MAL release and completed 1-year follow-up. The patients' preoperative and postoperative symptoms, use of analgesics, and body mass index were recorded. Patients' demographics and DUS and CTA findings were reviewed. Fisher exact and Student t-tests were used to identify correlation between patient or imaging variables and clinical outcomes. Results There were 19 patients (66%) who reported improvement in symptoms, and 18 (62%) decreased their use of analgesics; average body mass index increased by 0.2 (standard deviation, 1.97; range, -3.35 to 5.11). No celiac artery DUS finding (peak celiac artery velocity, angle of deflection, or change in preoperative to postoperative velocity) was predictive of successful clinical outcomes (P > .05). Similarly, no CTA finding (characteristic morphology, cross-sectional area, diameter, or location of the focal stenosis of the celiac artery) was associated with clinical outcomes (P > .05). Conclusions Clinical response to laparoscopic MAL release was favorable in two-thirds of patients; however, no specific imaging finding of stenosis was predictive of this response. Given that the severity of stenosis on conventional imaging had no impact on treatment efficacy, vascular compromise may not be the primary cause of pain in patients presenting with this syndrome. Future investigation incorporating the neurogenic basis of MALS pain, such as with diagnostic celiac ganglion blockade, would be helpful in further elucidating the enigmatic pathophysiologic process of MALS.

Overview

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Crossref · 10.1016/j.jvs.2018.04.062

Cites

25 of 25 references verified0 citation errors · 0 not checkable

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Citations

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Research works printed but not linked: 1

  1. Harjola, 1963, A rare obstruction of the coeliac artery, Ann Chir Gynaecol Fenn, 52, 547

Cited by

Metadata

Authors
Patel, M. V., Dalag, L., Weiner, A., Skelly, C., & Lorenz, J.
Affiliations
University of Chicago (US)
Corresponding author
Patel, Mikin V.
ORCID
Venue
Journal of Vascular Surgery
Publisher
Elsevier BV
Published
2019-02
Volume
69
Issue
2
Pages
462-469
ISSN
0741-5214 (ISSN-L)
DOI
10.1016/j.jvs.2018.04.062
OpenAlex
W2811374856
Cited by
31
References
25
Citations by year
2026: 2 · 2025: 4 · 2024: 9 · 2023: 6 · 2022: 1 · 2021: 3 · 2020: 5 · 2019: 1
FWCI
2.35
Type
journal article
Language
en
Open access
Licence
Locations
  • Journal of Vascular Surgery (publishedVersion)
  • PubMed (publishedVersion)
Topics
  • Health Sciences › Medicine › Surgery › Abdominal vascular conditions and treatments
  • Health Sciences › Medicine › Surgery › Vascular anomalies and interventions
  • Health Sciences › Medicine › Nephrology › Renal and Vascular Pathologies
Keywords
median arcuate ligament syndrome, celiac artery compression, duplex ultrasound, CT angiography, celiac artery stenosis, treatment response prediction, neuropathic pain
MeSH terms
Clinical Decision-Making, Computed Tomography Angiography, Median Arcuate Ligament Syndrome, Adult, Analgesics, Blood Flow Velocity, Celiac Artery, Female, Humans, Male, Middle Aged, Laparoscopy, Predictive Value of Tests, Regional Blood Flow, Retrospective Studies, Severity of Illness Index, Time Factors, Abdominal Pain, Treatment Outcome, Ultrasonography, Doppler, Color, Decompression, Surgical, Recovery of Function, Young Adult

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Contains information from the Semantic Scholar Academic Graph Datasets, made available under the ODC Attribution License (ODC-BY 1.0).

Semantic Scholar’s data is described in: Kinney, R., et al. (2023). The Semantic Scholar Open Data Platform. arXiv:2301.10140.