Collateral Circulation Develops in Stenosis of the Celiac Trunk, and Superior Mesenteric Artery

Purpose: Mesenteric circulation is provided by the celiac artery (CA), superior mesenteric artery (SMA), and inferior mesenteric artery (IMA). The collateral circulation between CA and SMA and between SMA and IMA plays a protective role against intestinal ischemia in case of narrowing or occlusion of the mesenteric vessels. In our study, it is aimed to determine the CA and SMA stenosis rates in patients with CA and SMA stenosis from angiography images, the occurrence of the collateral variations, and the frequency of these variations. Methods A total of 408 nonselective or selective CA and SMA angiographic images were taken of 215 patients (130 males, 85 females) who were admitted to Akdeniz University Hospital with symptoms of chronic mesenteric ischemia (CMI) were included. Angiography images were analyzed in regards to CA and SMA stenosis rates, and the collateral variations between mesenteric vessels. Results Stenosis of CA was observed in 14 patients whereas the stenosis of the SMA was observed in 12 patients. The most common collateral vessel in these patients was the gastroduodenal artery. Both stenoses of CA and SMA were found in 9 patients. The Rioalan arch was the most common type of collateral vessel in these patients. Conclusion It was observed that mesenteric circulation was mainly provided by gastroduodenal in patients with isolated CA or SMA stenosis or occlusion while in patients with stenosis or occlusion of both CA and SMA, mesenteric circulation was mainly provided by the Riolan arc. A significant increase was observed in the prominence of collateral vessels in patients with stenosis of more than 70%.