Intraoperative measurement of pressure gradient in median arcuate ligament syndrome as a rationale for radical surgical approach

Kód výsledku v IS VaVaI

<a href="https://www.isvavai.cz/riv?ss=detail&h=RIV%2F00216208%3A11110%2F18%3A10367535" target="_blank" >RIV/00216208:11110/18:10367535 - isvavai.cz</a>

Nalezeny alternativní kódy

RIV/00064165:_____/18:10367535

Výsledek na webu

<a href="https://doi.org/10.1080/00015458.2017.1371490" target="_blank" >https://doi.org/10.1080/00015458.2017.1371490</a>

DOI - Digital Object Identifier

<a href="http://dx.doi.org/10.1080/00015458.2017.1371490" target="_blank" >10.1080/00015458.2017.1371490</a>

Jazyk výsledku

angličtina

Název v původním jazyce

Intraoperative measurement of pressure gradient in median arcuate ligament syndrome as a rationale for radical surgical approach

Popis výsledku v původním jazyce

Background: Median arcuate ligament syndrome (MALS) describes clinical symptoms in patients with stenosis of the celiac artery due to external compression by the ligament. There is an ongoing debate, whether sole release of the median arcuate ligament warrants long-term relief of the symptoms. Materials and methods: Eight patients diagnosed with MALS underwent open surgical treatment beginning with the release of the ligament. Systemic pressure and pressure in the left gastric artery were measured before and after division of the median arcuate ligament and release of the celiac artery. In patients with persistent gradient above 15 mm Hg after the release a PTFE bypass was performed. Results: After the release, the pressure gradient decreased from 66 +- 19 to 48 +- 14 mm Hg (p = .001) and therefore in all patients either an aorto-celiac bypass (n = 6) or aorto-hepatic bypass (n = 2) was created. Consequently, the gradient decreased to 7 +- 2 mm Hg (p = .0001). One month postoperatively, three patients were free of symptoms and the rest reported relief of symptoms. Conclusions: Release of the celiac artery resulted in insufficient decrease of pressure gradient, which was achieved by bypassing the segment with favorable mid-term outcome. We believe that the effect of the release should always be assessed to decide on subsequent treatment.

Název v anglickém jazyce

Intraoperative measurement of pressure gradient in median arcuate ligament syndrome as a rationale for radical surgical approach

Popis výsledku anglicky

Background: Median arcuate ligament syndrome (MALS) describes clinical symptoms in patients with stenosis of the celiac artery due to external compression by the ligament. There is an ongoing debate, whether sole release of the median arcuate ligament warrants long-term relief of the symptoms. Materials and methods: Eight patients diagnosed with MALS underwent open surgical treatment beginning with the release of the ligament. Systemic pressure and pressure in the left gastric artery were measured before and after division of the median arcuate ligament and release of the celiac artery. In patients with persistent gradient above 15 mm Hg after the release a PTFE bypass was performed. Results: After the release, the pressure gradient decreased from 66 +- 19 to 48 +- 14 mm Hg (p = .001) and therefore in all patients either an aorto-celiac bypass (n = 6) or aorto-hepatic bypass (n = 2) was created. Consequently, the gradient decreased to 7 +- 2 mm Hg (p = .0001). One month postoperatively, three patients were free of symptoms and the rest reported relief of symptoms. Conclusions: Release of the celiac artery resulted in insufficient decrease of pressure gradient, which was achieved by bypassing the segment with favorable mid-term outcome. We believe that the effect of the release should always be assessed to decide on subsequent treatment.

Druh

J_imp - Článek v periodiku v databázi Web of Science

CEP obor

—

OECD FORD obor

30201 - Cardiac and Cardiovascular systems

Projekt

<a href="/cs/project/NV15-27941A" target="_blank" >NV15-27941A: Využití neantigenního rybího kolagenu při konstrukci implantátů a jako nosiče léků</a><br>

Návaznosti

I - Institucionalni podpora na dlouhodoby koncepcni rozvoj vyzkumne organizace

Rok uplatnění

2018

Kód důvěrnosti údajů

S - Úplné a pravdivé údaje o projektu nepodléhají ochraně podle zvláštních právních předpisů

Název periodika

Acta Chirurgica Belgica

ISSN

0001-5458

e-ISSN

—

Svazek periodika

118

Číslo periodika v rámci svazku

1

Stát vydavatele periodika

BE - Belgické království

Počet stran výsledku

6

Strana od-do

36-41

Kód UT WoS článku

000430091600006

EID výsledku v databázi Scopus

2-s2.0-85028894721