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Management of median arcuate ligament syndrome

Mohit K Manchella1, Vincent Wu1, Anahita Dua1

  • 1Division of Vascular and Endovascular Surgery, Massachusetts General Hospital, Boston, MA.

Journal of Vascular Surgery Cases and Innovative Techniques
|July 11, 2025
PubMed

Insights

Median arcuate ligament syndrome (MALS) can cause celiac artery compression, leading to visceral artery aneurysms. Early MALS diagnosis and treatment are crucial to prevent severe complications like ischemia.

Area of Science:

  • Vascular Surgery
  • Gastroenterology
  • Radiology

Background:

  • Median arcuate ligament syndrome (MALS) is a rare condition involving celiac artery compression.
  • Diagnosis can be challenging due to its complex presentation.

Observation:

  • A 51-year-old woman presented with multiple visceral aneurysms.
  • The aneurysms were located in the pancreaticoduodenal arcade.

Findings:

  • The patient's aneurysms were attributed to hemodynamic stress from chronic celiac artery occlusion caused by MALS.
  • This highlights a unique downstream complication of MALS.

Implications:

  • Early recognition and intervention in MALS are vital.
  • Prompt management can prevent serious complications such as aneurysm formation and ischemia.

Keywords:
AneurysmAssisted circulationCollateralEndovascularMedian arcuate ligament syndrome

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