Collateral pathways in patients with celiac axis stenosis: angiographic-spiral CT correlation.
Although celiac axis stenosis is a frequently encountered occlusive vascular disease, clinically significant ischemic bowel disease caused by celiac axis stenosis is rarely reported due to rich collateral circulation from the superior mesenteric artery (SMA). The most important and frequently encountered collateral vessels from the SMA in patients with celiac axis stenosis are the pancreaticoduodenal arcades and the dorsal pancreatic artery. Subtypes of collateral pathways via the dorsal pancreatic artery include a longitudinal pathway between the celiac branches and the SMA or its branches and a transverse pathway to either the splenic or gastroduodenal artery. A communicating channel between the right hepatic artery and the SMA can be a route for collateral circulation. Hepatic artery variants cause the development of unique collateral pathways that have different characteristics depending on the type of variant. These collateral pathways include intrahepatic interlobar collateral vessels, right gastric to left gastric arterial anastomoses, left hepatic to left gastric arterial anastomoses, and peribiliary arterial plexuses. Major collateral pathways in patients with celiac axis stenosis can be identified with spiral CT, and knowledge concerning this collateral circulation may be important for certain medical procedures such as interventional procedures for the management of hepatic tumors, pancreaticobiliary surgery, and liver transplantation.
Department of Radiology, Seoul National University College of Medicine, Institute of Radiation Medicine, 28 Yongon-Dong, Chongno-Gu, Korea.
Soon-Young
SY
Song
Jin Wook
JW
Chung
Jong Won
JW
Kwon
Joon Hee
JH
Joh
Sang Joon
SJ
Shin
Hyun Boem
HB
Kim
Jae Hyung
JH
Park
D000792:Angiography; D001157:Arterial Occlusive Diseases / Q000000981:diagnostic imaging*; D002445:Celiac Artery / Q000000981:diagnostic imaging*; D003097:Collateral Circulation; D006499:Hepatic Artery; D006801:Humans; D008638:Mesenteric Arteries; D010179:Pancreas / Q000098:blood supply; D014057:Tomography, X-Ray Computed