关键词: Aneurysm Aorto-iliac occlusive disease Arc of Riolan Celiac Trunk Chronic Mesenteric Ischemia Collateral Circulation Collateral pathway Compensary bloodflow Leriche’s Syndrome Meandering Artery Median Arcuate Ligament Syndrome Mesenteric Arteries Multidetector Computed Tomographic Angiography

来  源:   DOI:10.5334/jbr-btr.1203   PDF(Pubmed)

Abstract:
Multidetector computed tomographic angiography (MDCTA) is the new gold standard for diagnostic evaluation of the abdominal and/or mesenteric arteries. It is not invasive and provides a 2D and 3D global cartography of all abdominal arteries and that with only a limited amount of contrast media. MDCTA allows the optimal diagnosis of single or multiple arterial stenosis and easily analyses sometimes very complex collateral pathways. It constitutes a major advance to plan the arterial visceral safety of major commonly performed abdominal surgical procedures such as aorto-iliac surgery, endovascular aneurysm repair (EVAR), but also complex pancreatic and gastrointestinal or colonic surgery. It also allows to plan the most optimal strategy for revascularization of the mesenteric system through percutaneous angioplasty, stent placement or surgical bypass. This extensive pictorial review illustrates a large variety of situations which may be found during clinical practise. Single compression or stenosis of each digestive artery, combined and/or complex associations of stenosis and/or compressions of several arteries, secondary complications like aneurysms and classical but also sometimes unusual patterns of collateralization are richly illustrated. Specific syndromes comprising the median arcuate ligament syndrome (MALS) and the Leriche\'s syndrome are also discussed.
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