ArticleCureus2025
Successful Treatment of Median Arcuate Ligament Syndrome in the Hybrid Operating Room: A Report of Four Cases.
Article in Cureus, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
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1 citing paper in PubMed.
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Authors and funding
12 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Median arcuate ligament syndrome (MALS) is a rare disease characterized by abdominal pain attributed to the compression of the celiac trunk by the median arcuate ligament (MAL). In this study, we describe four patients with MALS who were successfully treated using surgical dissection of the MAL in a hybrid operating room that allowed intraoperative angiography. All four patients described in this report experienced abdominal pain. In three of these patients, MALS manifested as a consequence of rupture of a superior pancreaticoduodenal artery (PDA) aneurysm. The remaining patient was diagnosed with an asymptomatic PDA aneurysm through examination. The three cases of ruptured PDA aneurysms in our study required emergency embolization with intraoperative vascular radiology prior to the surgical dissection of the MAL. The standard therapeutic approach for MALS involves decompression of the celiac trunk by dissection of the MAL to obtain sufficient antegrade blood flow from the celiac artery (CA) to the proper hepatic artery. It is difficult to evaluate the efficacy of decompression of the CA using surgery alone because hemodynamic changes cannot be monitored intraoperatively. The surgeries were performed in a hybrid operating room, which contained intraoperative angiography and computed tomography equipment. It facilitated the evaluation of blood flow from the celiac trunk in real time, allowing the intraoperative verification of augmented blood perfusion within the CA, subsequent to the transection of the MAL. The postoperative course was uneventful, and none of the patients experienced any symptoms related to MALS after surgery. We describe the treatment of four patients who underwent successful hybrid surgery for MALS. Intraoperative angiography provided reliable information to evaluate the efficacy of the surgical division of the MAL.
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