Objective: To determine the incidence and etiologies of celiac axis stenosis in asymptomatic individuals.

Materials and Methods: This prospective study involved 400 consecutive patients (male: 319, female: 81) referred to us for celiac arteriography between April and July 1999. When celiac axis branches were opacified by collateral circulation during superior mesenteric arteriography, the presence of celiac axis stenosis was suspected; lateral projection celiac arteriography was performed and the pressure gradient was measured. The indicators used to determine whether or not celiac axis stenosis was significant were luminal narrowing of more than 50% and a resultant pressure gradient of at least 10 mmHg. Its etiology was determined on the basis of angiographic appearances and CT findings.

Results: Twenty-nine patients (7.3%) had celiac axis stenosis. The etiology of the condition was extrinsic compression due to the median arcuate ligament in 16 patients (55%) and atherosclerosis in three (10%), while in ten (35%) it was not determined. The incidence of celiac axis stenosis did not vary significantly according to sex, age and the presence of calcified aortic plaque representing atherosclerosis.

Conclusion: The incidence of hemodynamically significant celiac axis stenosis in this asymptomatic Korean population was 7.3% and the most important etiology was extrinsic compression by the median arcuate ligament of the diaphragm. Atherosclerosis was only a minor cause of the condition. t is known that generalized atherosclerosis and other vascular diseases commonly involve the celiac axis (CA), and in certain clinical situations the recognition of abnormalities in this vessel is very important or critical. Where the management of hepatic tumors involves procedures such as chemoembolization and hepatic artery infusion chemotherapy, the first step in such a procedure is selective catheterization of the CA. If this is severely stenotic or occluded, particular skill is required to pass a catheter through it or along alternative collateral pathways without causing arterial injury, and the procedure may sometimes have to be abandoned (1). The right gastroepiploic artery has recently proven reliable for use in coronary artery bypass grafting, a procedure which depends for its success on evaluation of the hemodynamic and anatomic status of the CA (2): if graft ischemia is to be prevented, such evaluation in liver transplant recipients should be preoperative. Vascular compromise of the multiple splanchnic arteries, including severe CA stenosis, can cause abdominal angina, though this is not common (3 5). Several studies have investigated the incidence and etiologies of CA stenosis. Derrick et al.(6) found that in 110 unselected autopsy cases, its incidence was 21%,