Open vascular treatment of median arcuate ligament syndrome

BMC Surgery

Research Article

Hubert Schelzig¹  Neslihan Ertas¹  Nikolaos Floros¹  Florian Simon¹  Mansur Duran² 

[1] Department of Vascular and Endovascular Surgery, Heinrich-Heine University Medical Center, Düsseldorf, Germany;Department of Vascular and Endovascular Surgery, Heinrich-Heine University Medical Center, Düsseldorf, Germany;Klinik für Gefäß- und Endovaskularchirurgie, Universitätsklinikum der Heinrich-Heine Universität, Moorenstr. 5, 40225, Düsseldorf, Germany;

关键词: Median arcuate ligament syndrome;    Dunbar syndrome;    Celiac artery compression syndrome;    Celiac artery;    Intestinal ischemia;   

DOI  :  10.1186/s12893-017-0289-8

 received in 2017-04-15, accepted in 2017-08-17,  发布年份 2017

来源: Springer

【 摘 要 】

BackgroundMedian arcuate ligament syndrome is a rare condition with abdominal symptoms. Accepted treatment options are open release of median arcuate ligament, laparoscopic release of edian arcuate ligament, robot-assisted release of median arcuate ligament and open vascular treatment. Here we aimed to evaluate the central priority of open vascular therapy in the treatment of median arcuate ligament syndrome.MethodsWe conducted a monocentric retrospective study between January 1996 and June 2016. Thirty-one patients with median arcuate ligament syndrome underwent open vascular surgery, including division of median arcuate ligament in 17 cases, and vascular reconstruction of the celiac artery in 14 cases.ResultsIn a 20-year period, 31 patients (n = 26 women, n = 5 men) were treated with division of median arcuate ligament (n = 17) or vascular reconstruction in combination with division of median arcuate ligament (n = 14). The mean age of patients was 44.8 ± 15.13 years. The complication rate was 16.1% (n = 5). Revisions were performed in 4 cases. The 30-day mortality rate was 0%. The mean in-hospital stay was 10.7 days. Follow-up data were obtained for 30 patients. The mean follow-up period was 52.2 months (range 2–149 months). Patients were grouped into a decompression group (n = 17) and revascularisation group (n = 13). The estimated Freedom From Symptoms rates were 93.3, 77.8, and 69.1% for the decompression group and 100, 83.3, and 83.3% for the revascularisation group after 12, 24 and 60 months respectively. We found no significant difference in the Freedom From Re-Intervention CA rates of the decompression (100% at 12, 24 and 60 months post-surgery) and revascularisation (100% at 12 months, and 91.7% at 24 and 60 months post-surgery) groups during follow-up (p = 0.26).ConclusionsOpen vascular treatment of median arcuate ligament syndrome is a safe, low mortality-risk procedure, with low morbidity rate. Treatment choice depends on the clinical and morphological situation of each patient.

【 授权许可】

CC BY   
© The Author(s). 2017