Mesenteric stenosis, collaterals, and compensatory blood flow

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Mesenteric stenosis, collaterals, and compensatory blood flow André S. van Petersen, MD, Jeroen J. Kolkman, MD, PhD, Robbert Meerwaldt, MD, PhD, Ad B. Huisman, MD, PhD, Job van der Palen, MSc, PhD, Clark J. Zeebregts, MD, PhD, Robert H. Geelkerken, MD, PhD Journal of Vascular Surgery Volume 60, Issue 1, Pages 111-119.e2 (July 2014) DOI: 10.1016/j.jvs.2014.01.063 Copyright © 2014 Society for Vascular Surgery Terms and Conditions

Fig 1 Studied collaterals between mesenteric arteries. CA, Celiac artery; GDA, gastroduodenal artery; HA, hepatic artery; IMA, inferior mesenteric artery; LGA, left gastric artery; PDA, pancreaticoduodenal artery; RA, renal artery; SA, splenic artery; SMA, superior mesenteric artery. Journal of Vascular Surgery 2014 60, 111-119.e2DOI: (10.1016/j.jvs.2014.01.063) Copyright © 2014 Society for Vascular Surgery Terms and Conditions

Fig 2 A, Collateral visible on selective injection only (grade 1) in a patient with stenosis of the celiac artery (CA). B, Collateral visible on nonselective visceral angiography (grade 2) in a patient with stenosis of the CA. GDA, Gastroduodenal artery; HA, hepatic artery; SA, splenic artery; SMA, superior mesenteric artery. Journal of Vascular Surgery 2014 60, 111-119.e2DOI: (10.1016/j.jvs.2014.01.063) Copyright © 2014 Society for Vascular Surgery Terms and Conditions

Fig 3 Effect of stenosis in the celiac artery (CA) on duplex velocity parameters of the CA and superior mesenteric artery (SMA) during expiration. Data are shown as mean ± standard error of the mean. PSV, Peak systolic velocity. *P < .005 comparing stenosis vs no stenosis. Journal of Vascular Surgery 2014 60, 111-119.e2DOI: (10.1016/j.jvs.2014.01.063) Copyright © 2014 Society for Vascular Surgery Terms and Conditions

Fig 4 Patients with an angiographically normal superior mesenteric artery (SMA): effect of grade of celiac artery (CA) stenosis on SMA peak systolic velocity (PSV) during expiration. Data are shown as mean ± standard error of the mean. P = .009, analysis of variance between groups; *P < .05, post hoc Tukey test compared with normal. Journal of Vascular Surgery 2014 60, 111-119.e2DOI: (10.1016/j.jvs.2014.01.063) Copyright © 2014 Society for Vascular Surgery Terms and Conditions

Fig 5 Patients with an angiographically normal superior mesenteric artery (SMA) with and without ≥70% celiac artery (CA) stenosis: effect of existence of pathologic collateral pathways on SMA peak systolic velocity (PSV) during expiration. Data are shown as mean ± standard error of the mean. *P < .05 comparing collateral vs no collateral and stenosis vs no stenosis. Journal of Vascular Surgery 2014 60, 111-119.e2DOI: (10.1016/j.jvs.2014.01.063) Copyright © 2014 Society for Vascular Surgery Terms and Conditions

Fig 6 Patients with an angiographically normal superior mesenteric artery (SMA): effect of existence and type of collateral pathways on SMA duplex velocity parameters. Data are shown as mean ± standard error of the mean. PSV, Peak systolic velocity. *P < .05 comparing groups (analysis of variance with post hoc Tukey test) compared with no collateral. Journal of Vascular Surgery 2014 60, 111-119.e2DOI: (10.1016/j.jvs.2014.01.063) Copyright © 2014 Society for Vascular Surgery Terms and Conditions

Fig 7 Effect of stenosis in the superior mesenteric artery (SMA) on duplex velocity parameters of the celiac artery (CA) and SMA during expiration. Data are shown as mean ± standard error of the mean. PSV, Peak systolic velocity. *P < .005 comparing stenosis vs no stenosis. Journal of Vascular Surgery 2014 60, 111-119.e2DOI: (10.1016/j.jvs.2014.01.063) Copyright © 2014 Society for Vascular Surgery Terms and Conditions