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. 2024 Jul 31;39(1):120.
doi: 10.1007/s00384-024-04691-y.

The value of treatment choice and clinical prognosis for Riolan's arch in chronic superior mesenteric artery ischaemic disease

Mengqiang Zhang  1 , Subinuer Maimaitiaili  1 , Run Ji  2 , Chen Tang  1 , Jing Cai  1 , Zhao Liu  1 , Tong Qiao  3
Affiliations

The value of treatment choice and clinical prognosis for Riolan's arch in chronic superior mesenteric artery ischaemic disease

Mengqiang Zhang et al. Int J Colorectal Dis. .

Abstract

Objective: To explore the value of treatment choice and clinical prognosis for Riolan's arch in chronic superior mesenteric artery (SMA) ischaemic disease in vascular surgery.

Methods: The clinical data of 215 patients with SMA ischaemic disease (41 cases with Riolan's arch and 174 cases without) admitted to the Department of Vascular Surgery, Affiliated Drum Tower Hospital, Medical School of Nanjing University (China) from January 2019 to April 2023 were reviewed. Clinical characteristics, imaging findings, treatment, perioperative complications, and patient follow-up data were analysed to observe the impact of Riolan's arch on the prognosis of patients with SMA ischaemic disease.

Results: There were significant differences in body mass index (Riolan's arch group: 22.82 ± 3.28 vs 24.03 ± 4.26 in non-Riolan's arch group, P = 0.049), Takayasu's arteritis (4.9% vs 0, respectively, P = 0.036), and secondary intervention (3.3% vs 1.9%, respectively, P < 0.001) between the two groups. Propensity score matching was used to exclude the effect of baseline data on patient outcomes. There were significant differences related to therapy method (conservative treatment, Riolan's arch group: 24.1% vs 39.7% in the non-Riolan's arch group; operative treatment, Riolan's arch group: 51.7% vs 20.7% in the non-Riolan's arch group, P = 0.014), as well as in-hospital time (9.79 ± 4.20 vs 6.86 ± 4.32, respectively, P = 0.011). There was no statistically significant difference in Kaplan-Meier curves between the two groups (log-rank test P = 0.476).

Conclusions: Riolan's arch plays an important compensatory role in SMA ischaemic disease, especially in chronic disease. We found significant differences in the treatment methods and length of hospital stay of Riolan's arch, which may suggest that Riolan's arch has some reference value in the choice of treatment mode.

Keywords: Collateral circulatory vessel; Prognosis; Riolan’s arch; Superior mesenteric artery.

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Conflict of interest statement

The authors declare no competing interests.

Figures

Fig. 1
Fig. 1
Schematic of the diameter measurement of the Riolan arch
Fig. 2
Fig. 2
Flow chart of the patient screening. A total of 316 patients with SMA-related diseases were selected and 215 were selected after screening. After propensity score matching, 29 patients were in group Riolan and 29 were in group non-Riolan. SMA, superior mesenteric artery; CTA, computed tomography angiogram
Fig. 3
Fig. 3
Cumulative Kaplan–Meier estimates for groups Riolan and non-Riolan
Fig. 4
Fig. 4
A Riolan arch in patients with abdominal aortic stenosis. B IMA is protected during abdominal aortic stent implantation. C IMA was anastomosed to artificial vessels. D CTA after abdominal aortic resection with artificial vessel replacement. IMA, inferior mesenteric artery; CTA, computed tomography angiogram
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