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Treatment of celiac artery compression syndrome: does it really exist?

Peter Gloviczki1, Audra A Duncan

  • 1Division of Vascular Surgery, Gonda Vascular Center, Mayo Clinic, Rochester, Minnesota 55905, USA. gloviczki.peter@mayo.edu

Perspectives in Vascular Surgery and Endovascular Therapy
|October 4, 2007
PubMed

Insights

Celiac artery compression syndrome, though controversial, can be diagnosed via imaging and may require surgical intervention. Surgical division of the median arcuate ligament offers good outcomes for patients with chronic ischemia.

Area of Science:

  • Vascular Surgery
  • Gastroenterology
  • Diagnostic Imaging

Background:

  • Celiac artery compression syndrome (CACS) is a debated condition where the celiac artery is compressed.
  • Diagnosis can be challenging, often requiring advanced imaging techniques.

Purpose of the Study:

  • To review diagnostic methods and treatment outcomes for celiac artery compression syndrome.
  • To evaluate the efficacy of surgical and minimally invasive interventions for CACS.

Main Methods:

  • Review of diagnostic modalities including duplex scanning, CT, MRI, and aortography.
  • Assessment of preoperative diagnostic tools like ganglion block and gastric tonometry.
  • Analysis of surgical outcomes following median arcuate ligament division and celiac artery reconstruction.
  • Evaluation of laparoscopic techniques and stenting for CACS management.

Main Results:

  • Imaging confirms celiac artery compression by diaphragmatic crus, median arcuate ligament, or fibrous tissue.
  • Preoperative ganglion block and gastric tonometry aid in predicting treatment success.
  • Open surgical repair (median arcuate ligament division with reconstruction) yields good results for chronic ischemia and exercise-induced pain.
  • Laparoscopic division of the median arcuate ligament with celiac artery stenting is effective for selected patients.
  • Patients with atypical pain or psychiatric history show limited benefit from surgery.

Conclusions:

  • Celiac artery compression syndrome diagnosis and management require careful patient selection.
  • Surgical intervention, particularly median arcuate ligament division, is effective for symptomatic patients.
  • Minimally invasive laparoscopic approaches combined with stenting show promise for select cases.

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