Angioplasty in the treatment of median arcuate ligament compression syndrome combined with splenic aneurysm: A case report

Median Arcuate Ligament Syndrome (MALS) is characterized by clinical manifestations resulting from the direct compression of the celiac trunk by the median arcuate ligament. Symptoms typically include postprandial abdominal pain, nausea, vomiting, and weight loss. The patient, a 69-year-old female,...

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Main Authors: Sai Xiang, Xiaodong Wang, Jifu Lai
Format: Article
Language:English
Published: Elsevier 2024-12-01
Series:Annals of Vascular Surgery - Brief Reports and Innovations
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Online Access:http://www.sciencedirect.com/science/article/pii/S2772687824001004
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author Sai Xiang
Xiaodong Wang
Jifu Lai
author_facet Sai Xiang
Xiaodong Wang
Jifu Lai
author_sort Sai Xiang
collection DOAJ
description Median Arcuate Ligament Syndrome (MALS) is characterized by clinical manifestations resulting from the direct compression of the celiac trunk by the median arcuate ligament. Symptoms typically include postprandial abdominal pain, nausea, vomiting, and weight loss. The patient, a 69-year-old female, presented with complaints of coughing, abdominal pain, and weight loss following positional changes. Physical examination revealed a systolic vascular murmur in the mid and upper abdomen, which was accentuated during exhalation. Abdominal aortic CTA indicated severe stenosis at the origin of the celiac trunk and localized dilation of the splenic artery. These findings strongly suggested MALS. In this case, we proceeded with endovascular treatment, achieving early symptom relief. Given the rarity of MALS and its nature as a diagnosis of exclusion, the diagnosis and treatment approach may lack clarity. Symptom relief can be achieved with a variety of interventions including celiac ganglionectomy as well as open, laparoscopic, or robotic intervention. Endovascular treatment for MALS has been questioned in the past, the diagnosis and treatment of MALS must be patient-centered, tailored to the individual needs of each patient.
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spelling doaj-art-a96fa9bdfdb84562946a7028118bd8e52025-08-20T02:34:23ZengElsevierAnnals of Vascular Surgery - Brief Reports and Innovations2772-68782024-12-014410034810.1016/j.avsurg.2024.100348Angioplasty in the treatment of median arcuate ligament compression syndrome combined with splenic aneurysm: A case reportSai Xiang0Xiaodong Wang1Jifu Lai2Zhejiang Chinese Medical University, No. 548 Binwen Road, Binjiang District, Hangzhou City, Zhejiang, MI 310053, China; Corresponding author.Tongde Hospital of Zhejiang Province, No. 234 Gucui Road, Hangzhou, Zhejiang Province, MI 310012, ChinaZhejiang Provincial People's Hospital, No. 158 Shangtang Road, Gongshu District, Hangzhou City, Zhejiang, MI 314408, ChinaMedian Arcuate Ligament Syndrome (MALS) is characterized by clinical manifestations resulting from the direct compression of the celiac trunk by the median arcuate ligament. Symptoms typically include postprandial abdominal pain, nausea, vomiting, and weight loss. The patient, a 69-year-old female, presented with complaints of coughing, abdominal pain, and weight loss following positional changes. Physical examination revealed a systolic vascular murmur in the mid and upper abdomen, which was accentuated during exhalation. Abdominal aortic CTA indicated severe stenosis at the origin of the celiac trunk and localized dilation of the splenic artery. These findings strongly suggested MALS. In this case, we proceeded with endovascular treatment, achieving early symptom relief. Given the rarity of MALS and its nature as a diagnosis of exclusion, the diagnosis and treatment approach may lack clarity. Symptom relief can be achieved with a variety of interventions including celiac ganglionectomy as well as open, laparoscopic, or robotic intervention. Endovascular treatment for MALS has been questioned in the past, the diagnosis and treatment of MALS must be patient-centered, tailored to the individual needs of each patient.http://www.sciencedirect.com/science/article/pii/S2772687824001004Median arcuate ligament syndrome (MALS)Mesenteric ischemiaAngioplastyInterventional therapyComputed tomography angiography (CTA)Vascular stent implantation
spellingShingle Sai Xiang
Xiaodong Wang
Jifu Lai
Angioplasty in the treatment of median arcuate ligament compression syndrome combined with splenic aneurysm: A case report
Annals of Vascular Surgery - Brief Reports and Innovations
Median arcuate ligament syndrome (MALS)
Mesenteric ischemia
Angioplasty
Interventional therapy
Computed tomography angiography (CTA)
Vascular stent implantation
title Angioplasty in the treatment of median arcuate ligament compression syndrome combined with splenic aneurysm: A case report
title_full Angioplasty in the treatment of median arcuate ligament compression syndrome combined with splenic aneurysm: A case report
title_fullStr Angioplasty in the treatment of median arcuate ligament compression syndrome combined with splenic aneurysm: A case report
title_full_unstemmed Angioplasty in the treatment of median arcuate ligament compression syndrome combined with splenic aneurysm: A case report
title_short Angioplasty in the treatment of median arcuate ligament compression syndrome combined with splenic aneurysm: A case report
title_sort angioplasty in the treatment of median arcuate ligament compression syndrome combined with splenic aneurysm a case report
topic Median arcuate ligament syndrome (MALS)
Mesenteric ischemia
Angioplasty
Interventional therapy
Computed tomography angiography (CTA)
Vascular stent implantation
url http://www.sciencedirect.com/science/article/pii/S2772687824001004
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AT xiaodongwang angioplastyinthetreatmentofmedianarcuateligamentcompressionsyndromecombinedwithsplenicaneurysmacasereport
AT jifulai angioplastyinthetreatmentofmedianarcuateligamentcompressionsyndromecombinedwithsplenicaneurysmacasereport