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Title: Median Arcuate Ligament Syndrome: A Single-Center Experience with 23 Patients

Abstract

BackgroundMedian arcuate ligament syndrome (MALS) is a rare entity that occurs when the median arcuate ligament of the diaphragm is low-lying, causing a compression to the underlying celiac trunk. We reviewed the vascular changes associated with MALS in an effort to emphasize the seriousness of this disease and the complications that may result.MethodsThis is a retrospective descriptive analysis of 23 consecutive patients diagnosed with MALS between January 1, 2012 and December 31, 2015 at a tertiary medical center. Computed tomographic (CT) scans, medical records, and patient follow-up were reviewed.ResultsThe number of patients included herein was 23. The median age was 56 years (17–83). Sixteen patients (69.6%) had a significant arterial collateral circulation. Eleven patients (47.8%) were found to have visceral artery aneurysms; 4 patients (36.4%) bled secondary to aneurysm rupture. All ruptured aneurysms were treated with endovascular approach. The severity of the hemodynamic changes appears to be greater with complete occlusion,ConclusionsMALS causes pathological hemodynamic changes within the abdominal vasculature. Follow-up is advised for patients who develop a collateral circulation. Resulting aneurysms should preferably be treated when the size ratio approaches three. Treatment of these aneurysms can be done via an endovascular approach coupled with possible celiac artery decompression to restore physiologicmore » blood flow.« less

Authors:
 [1];  [2];  [1];  [3]; ; ;  [2]; ;  [1]
  1. American University of Beirut Medical Center, Division of Interventional Radiology, Department of Radiology (Lebanon)
  2. American University of Beirut Medical Center, Department of Surgery (Lebanon)
  3. Imperial College-London Faculty of Medicine, Division of Interventional Radiology, Department of Radiology (United Kingdom)
Publication Date:
OSTI Identifier:
22645219
Resource Type:
Journal Article
Resource Relation:
Journal Name: Cardiovascular and Interventional Radiology; Journal Volume: 40; Journal Issue: 5; Other Information: Copyright (c) 2017 Springer Science+Business Media New York and the Cardiovascular and Interventional Radiological Society of Europe (CIRSE); http://www.springer-ny.com; Country of input: International Atomic Energy Agency (IAEA)
Country of Publication:
United States
Language:
English
Subject:
62 RADIOLOGY AND NUCLEAR MEDICINE; ARTERIES; BIOMEDICAL RADIOGRAPHY; BLOOD FLOW; COMPUTERIZED TOMOGRAPHY; DIAGNOSIS; DIAPHRAGM; LIGAMENTS; MEDICAL ESTABLISHMENTS; MEDICAL RECORDS; PATIENTS; REVIEWS; RUPTURES

Citation Formats

Nasr, Layla A., Faraj, Walid G., Al-Kutoubi, Aghiad, Hamady, Mohamad, Khalifeh, Mohamad, Hallal, Ali, Halawani, Hamzeh M., Wazen, Joelle, and Haydar, Ali A., E-mail: ah24@aub.edu.lb. Median Arcuate Ligament Syndrome: A Single-Center Experience with 23 Patients. United States: N. p., 2017. Web. doi:10.1007/S00270-016-1560-6.
Nasr, Layla A., Faraj, Walid G., Al-Kutoubi, Aghiad, Hamady, Mohamad, Khalifeh, Mohamad, Hallal, Ali, Halawani, Hamzeh M., Wazen, Joelle, & Haydar, Ali A., E-mail: ah24@aub.edu.lb. Median Arcuate Ligament Syndrome: A Single-Center Experience with 23 Patients. United States. doi:10.1007/S00270-016-1560-6.
Nasr, Layla A., Faraj, Walid G., Al-Kutoubi, Aghiad, Hamady, Mohamad, Khalifeh, Mohamad, Hallal, Ali, Halawani, Hamzeh M., Wazen, Joelle, and Haydar, Ali A., E-mail: ah24@aub.edu.lb. Mon . "Median Arcuate Ligament Syndrome: A Single-Center Experience with 23 Patients". United States. doi:10.1007/S00270-016-1560-6.
@article{osti_22645219,
title = {Median Arcuate Ligament Syndrome: A Single-Center Experience with 23 Patients},
author = {Nasr, Layla A. and Faraj, Walid G. and Al-Kutoubi, Aghiad and Hamady, Mohamad and Khalifeh, Mohamad and Hallal, Ali and Halawani, Hamzeh M. and Wazen, Joelle and Haydar, Ali A., E-mail: ah24@aub.edu.lb},
abstractNote = {BackgroundMedian arcuate ligament syndrome (MALS) is a rare entity that occurs when the median arcuate ligament of the diaphragm is low-lying, causing a compression to the underlying celiac trunk. We reviewed the vascular changes associated with MALS in an effort to emphasize the seriousness of this disease and the complications that may result.MethodsThis is a retrospective descriptive analysis of 23 consecutive patients diagnosed with MALS between January 1, 2012 and December 31, 2015 at a tertiary medical center. Computed tomographic (CT) scans, medical records, and patient follow-up were reviewed.ResultsThe number of patients included herein was 23. The median age was 56 years (17–83). Sixteen patients (69.6%) had a significant arterial collateral circulation. Eleven patients (47.8%) were found to have visceral artery aneurysms; 4 patients (36.4%) bled secondary to aneurysm rupture. All ruptured aneurysms were treated with endovascular approach. The severity of the hemodynamic changes appears to be greater with complete occlusion,ConclusionsMALS causes pathological hemodynamic changes within the abdominal vasculature. Follow-up is advised for patients who develop a collateral circulation. Resulting aneurysms should preferably be treated when the size ratio approaches three. Treatment of these aneurysms can be done via an endovascular approach coupled with possible celiac artery decompression to restore physiologic blood flow.},
doi = {10.1007/S00270-016-1560-6},
journal = {Cardiovascular and Interventional Radiology},
number = 5,
volume = 40,
place = {United States},
year = {Mon May 15 00:00:00 EDT 2017},
month = {Mon May 15 00:00:00 EDT 2017}
}