ReviewCureus2026
Current Evidence on the Treatment of Median Arcuate Ligament Syndrome: A Comprehensive Review.
Review in Cureus, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
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.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
0 citing papers in PubMed.
No citing paper in PubMed yet.
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
4 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Median arcuate ligament syndrome (MALS) is an uncommon and controversial disorder characterized by chronic abdominal symptoms associated with extrinsic compression of the celiac artery (CA) and adjacent celiac plexus by the median arcuate ligament (MAL). Although anatomical CA compression is relatively common, only a small proportion of individuals develop clinically significant disease, making accurate diagnosis and patient selection fundamental to successful treatment. This narrative review critically evaluates the current evidence on the management of MALS, focusing on patient selection, the role of celiac plexus blockade, operative decompression techniques, adjunctive revascularization, treatment outcomes, and postoperative surveillance. A comprehensive literature search of PubMed/MEDLINE, Scopus, Web of Science, and the Cochrane Library was performed up to June 2026, with an emphasis on clinical guidelines, systematic reviews, multicenter studies, and comparative series. Contemporary evidence supports a multidisciplinary, exclusion-based diagnostic approach, integrating compatible symptoms with dynamic vascular imaging, while recognizing that radiographic CA compression alone is insufficient to establish the diagnosis. Surgical MAL release, often combined with celiac plexus neurolysis, remains the cornerstone of treatment, with minimally invasive approaches generally favored because of lower perioperative morbidity and faster recovery. Primary endovascular treatment without ligament release is not recommended, whereas staged revascularization should be reserved for selected patients with persistent symptoms and objectively significant residual stenosis after adequate decompression. Despite encouraging outcomes in carefully selected patients, the available evidence is limited by retrospective study designs, heterogeneous diagnostic criteria, inconsistent outcome reporting, and a lack of randomized controlled trials. Future prospective studies and standardized reporting are required to optimize patient selection and establish evidence-based treatment algorithms.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.