Clinical Outcomes Following Median Arcuate Ligament Release in Patients Responsive to Celiac Plexus Block.

To determine if symptom relief with celiac plexus block (CPB) was associated with favorable clinical outcomes after median arcuate ligament release (MALR) surgery. A retrospective review was performed from January 2000 to December 2021. Fifty-seven patients (42 females, 15 males; mean age 43 years (range:18-84years)), with clinical and radiographic features suggestive of median arcuate ligament syndrome (MALS), underwent CT-guided percutaneous celiac plexus block for suspected MALS. Clinical outcomes of celiac plexus block and median arcuate ligament surgery were correlated. Adverse events were classified according to the SIR guidelines. CT-guided percutaneous celiac plexus block was successfully performed in all 57 (100%) patients with suspected MALS. A cohort of 38 (67%) patients had clinical improvement with celiac plexus block. A subset of 28 (74%) patients of this group subsequently underwent open median arcuate release surgery. 27 (96%) respondents to CPB had favorable clinical outcome with surgery. There was one (4 %) celiac plexus block related mild adverse event. There were no moderate, severe, or life-threatening adverse events. Patients who responded to CPB were selected to undergo surgery, and 96% of them improved.

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