Venous Adventitial Cystic Disease: A Review of 45 Cases Treated Since 1963.

Corey Bascone,Mazen Iqbal,Michael Cicchillo,Mauricio Szuchmacher,Patrick Narh-Martey,Kambhampaty V Krishnasastry

doi:10.1155/2016/5287697

Abstract

Purpose. To review and identify the most accurate ways of diagnosing and treating adventitial cystic disease (ACD) of the venous system. Methods. Cases of ACD were collected through three popular medical databases, including PubMed, Cochrane, OVID, and MEDLINE. After reviewing the literature, the sites of occurrence of 323 cases of adventitial cystic disease were documented, and all cases of arterial ACD were excluded. The clinical features, treatment, and subsequent course of 45 cases of venous ACD are included in this paper. Results. After reviewing all 45 cases of venous ACD , we have confirmed that the most common vessel affected is the common femoral vein, which reproduces the most common symptom of venous ACD: asymmetric lower extremity swelling worsening over time. Conclusion. Venous ACD most commonly affects the common femoral vein. When unilateral leg swelling occurs with or without a noticeable mass, ACD should be considered. It is best confirmed with CT venography and the treatment of choice is transluminal cyst evacuation and excision.

Highlights

Adventitial cystic disease (ACD) is an uncommon vascular anomaly that is characterized by a collection of mucinous materials in the adventitia of an affected blood vessel
When ACD does affect the venous system, it is often mistakenly diagnosed as deep vein thrombosis
Based on our review of all available literature, the main focus of this study is to conclude on the best modalities with which to successfully diagnose and treat adventitial cystic disease of the venous system

Summary

Introduction

Adventitial cystic disease (ACD) is an uncommon vascular anomaly that is characterized by a collection of mucinous materials in the adventitia of an affected blood vessel. These collections of materials are thought to be histologically similar to ganglia and have a propensity for extrinsically narrowing the lumen of blood vessels. This rare disease was first described in the external iliac artery in 1947 [1]. Based on our review of all available literature, the main focus of this study is to conclude on the best modalities with which to successfully diagnose and treat adventitial cystic disease of the venous system

Methods

Results

Discussion

Conclusion