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

## TL;DR

This study examines how Riolan’s arch affects treatment choices and outcomes in patients with chronic superior mesenteric artery ischaemic disease.

## Contribution

The study identifies Riolan’s arch as a factor influencing treatment decisions and hospitalization duration in SMA ischaemic disease.

## Key findings

- Patients with Riolan’s arch had different treatment preferences and longer hospital stays compared to those without.
- Riolan’s arch appears to provide compensatory benefits in chronic SMA ischaemic disease.
- No significant difference in overall survival was found between the two groups.

## Abstract

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.

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.

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).

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.

The online version contains supplementary material available at 10.1007/s00384-024-04691-y.