Korean J Radiol.  2001 Mar;2(1):8-13. 10.3348/kjr.2001.2.1.8.

Celiac Axis Stenosis: Incidence and Etiologies in Asymptomatic Individuals

• Park CM
• Chung JW
• Kim HB
• Shin SJ
• Park JH

• KMID: 754117
• DOI: http://doi.org/10.3348/kjr.2001.2.1.8

Abstract

OBJECTIVE
To determine the incidence and etiologies of celiac axis stenosis in asymptomatic individuals. MATERIALS AND METHODS: This prospective study involved 400 consecutive patients (male: 319, female: 81) referred to us for celiac arteriography between April and July 1999. When celiac axis branches were opacified by collateral circu-lation during superior mesenteric arteriography, the presence of celiac axis stenosis was suspected; lateral projection celiac rteriography was performed and the pressure gradient was measured. The indicators used to determine whether or not celiac axis stenosis was significant were luminal narrowing of more than 50% and a resultant pressure gradient of at least 10 mmHg. Its etiology was deter-mined on the basis of angiographic appearances and CT findings. RESULTS: Twenty-nine patients (7.3%) had celiac axis stenosis. The etiology of the condition was extrinsic compression due to the median arcuate ligament in 16 patients (55%) and atherosclerosis in three (10%), while in ten (35%) it was not determined. The incidence of celiac axis stenosis did not vary significantly according to sex, age and the presence of calcified aortic plaque representing atherosclerosis. CONCLUSION: The incidence of hemodynamically significant celiac axis stenosis in this asymptomatic Korean population was 7.3% and the most important etiology was extrinsic compression by the median arcuate ligament of the diaphragm. Atherosclerosis was only a minor cause of the condition.

Keyword

Arteries, stenosis or obstruction; Arteries, celiac; Angiography Computed tomography (CT)

MeSH Terms

Angiography
*Celiac Artery
Constriction, Pathologic/epidemiology/etiology/radiography
Female
Human
Incidence
Male
Middle Age
Peripheral Vascular Diseases/epidemiology/etiology/*radiography
Prospective Studies
Tomography, X-Ray Computed

Figure

• 

  Fig. 1 A 50-year-old man with hemodynamically total or near-total occlusion of the CA due to extrinsic compression by MAL. A. Angiogram of the SMA reveals the celiac trunk and all CA branches including the common hepatic, splenic and left gastric artery (arrow) indicating hemodynamically total or near-total occlusion of the CA. B. Angiogram of the lateral CA reveals acute downward angulation with superior notching of the proximal CA (arrow). C. Enhanced abdominal CT scan reveals compression of the proximal CA by MAL (white arrows).

• 

  Fig. 2 A 54-year-old man with significant CA stenosis due to atherosclerosis. A. Angiogram of the SMA reveals the proper hepatic artery (arrow), seen through the pancreaticoduodenal arcade (small arrows). B. CT scan indicates the presence of calcified atheromatous plaque (white arrow) obstructing the CA orifice. C. Concentric luminal narrowing of the CA orifice (arrow) is demonstrated by lateral projection angiogram of the CA.

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