Cases Of Cystic Adventitial Disease Research Articles

Cystic Adventitial Popliteal Disease: Personal Experience and Literature Review

Background: Cystic adventitial disease (CAD) primarily affects arteries and is described as a rare vascular disorder characterized by fluid accumulation in the adventitial layer of a vessel which may cause luminal narrowing or even complete occlusion. Nowadays different pathogenetic theories exist as well as different treatment solution. Case Report: We report two cases of cystic adventitial disease of the popliteal artery treated over the last 4 years in healthy men. Both experienced the sudden onset of intermittent calf claudication; one also presented blue toe syndrome. In both cases the diagnose was confirmed after open surgery and histological evaluation. Complete resection and autologous vein bypass were performed in one case; complete resection and direct end to end anastomosis in the others. Discussion: Cystic adventitial disease is a rare vascular disorder with different interesting theories on its aetiology. Treatment options include percutaneous ultrasound-guided aspiration, endovascular approaches and open surgical cyst excision with or without direct reconstruction. In our Institution, we faced two popliteal CAD cases; open surgery represented the treatment strategy for both: in the first case an autologous vein bypass was performed, while in the second case the artery contiguity was restored with an end-to-end anastomosis. Both patients experienced full relief of symptoms without any recurrence of the disease. Conclusion: Even if rare, popliteal artery CAD has to be suspected in young healthy patients who refer the sudden onset of acute or sub-acute symptoms related to peripheral arterial occlusive disease. Differential diagnose between popliteal entrapment syndrome and popliteal aneurysms is not always easy. When CAD is suspected or diagnosed a conventional surgical approach is recommended.

Cystic adventitial disease of femoral vein presenting as enlarging lower limb swelling and pain: Two case reports and review of the literature.

Cystic adventitial disease (CAD) is a condition that mainly affects the arterial system but rarely involves the venous system. The present study reported on two cases of CAD of femoral veins. The clinical manifestations in the two patients included pain and swelling of the lower limbs, but they had no risk factors for venous thrombosis. Color ultrasonography indicated cystic space-occupying lesions around the femoral veins, and enhanced computed tomography (CT) revealed vascular compression and space-occupying properties of the femoral veins. The two patients underwent open surgery, the postoperative treatment was uneventful, and swelling and tenderness were completely resolved. The pathological examination confirmed CAD of femoral vein in the two patients. The enhanced CT venography scan indicated patency of the femoral vein in the two patients following the operation. The circumferences of the two patients' lower limbs had returned to normal at the 2-month follow-up. A review of the literature was performed, and the presentation, diagnosis, treatment and pathology of this rare condition were discussed.

Two cases of cystic adventitial disease of the popliteal artery

Two cases of cystic adventitial disease of the popliteal artery

Cystic Adventitial Disease of the Common Femoral Vessels

Cystic adventitial disease (CAD) is a rare vascular disorder that is most seen in the popliteal artery. Only a small number of cases involved in femoral artery or vein have been reported and it becomes more difficult to be recognized preoperatively, especially when the femoral artery or vein is affected. We presented 2 cases of CAD affecting the femoral artery or vein, all of which received the "circumferential removal of the adventitia" with promising results. The presentation, investigation, and treatment of CAD were discussed.

Cystic adventitial disease of the popliteal artery: report of two cases and review of the literature

Cystic adventitial disease (CAD) is a rare vascular disease that causes a localized stenosis or occlusion in absence of alterations of blood vessels in other sites of the body. CAD is predominantly located to the popliteal artery, although cases have been described involving other arteries. Typically it affects young men with minimal cardiovascular risk factors, presenting a short history of progressive claudication. Imaging is based on US, CTA and MRA. Suspected diagnosis is confirmed at the time of the surgery. We report two cases of CAD involving the popliteal artery. In the first case a 59 year-old man was treated by resection of the popliteal artery and a reversed saphenous vein was used to restore circulation. In the second case a 53 year-old man was treated by resection of the popliteal artery and a cryo-preserved arterial graft was used to restore circulation. We also made a review of the literature on this subject.

CYSTIC ADVENTITIAL DISEASE OF THE POPLITEAL ARTERY: REPORT ON THREE CASES AND REVIEW OF THE LITERATURE

During the past nine years three cases of cystic adventitial disease of the popliteal artery have been diagnosed and treated in our medical institution. Different approaches were used in the treatment in all these cases. The purpose of this report is to summarise the current knowledge of the etiology, presentation, diagnostics and treatment of this condition, with the addition of new cases. Information about three new cases is presented and discussed together with that from the relevant publications obtained from the Pubmed database. Results. In the first case resection with synthetic graft interposition was used. Nine years after the surgery the patient is without any signs of recurrence, but he experienced local thrombolysis of the occluded graft and repeated PTA of hemodynamically significant anastomotic stenoses. The second case treated with US-guided aspiration has demanded repeated reinterventions due to recurrence; nevertheless, the result is satisfactory. In the last instance, the cyst was evacuated and excised. Six months after the surgery the patient is symptom-free and without signs of recurrence. CAD of the popliteal artery is a rare vascular condition. However, it must be considered in the differential diagnosis, especially in middle-aged male patients without evidence of atherosclerotic disease in whom intermittent claudication has developed suddenly with a rapid progression or with fluctuation in severity. Duplex ultrasound and MRA are the the best diagnostic methods. Based on the existing knowledge, the treatment of choice is surgery (either evacuation with the removal of the cystic wall or resection and grafting).

Critical ischaemia complicating cystic adventitial disease of the popliteal artery

Cases of cystic adventitial disease of the popliteal artery are presented to highlight the level of alertness necessary to recognise the characteristic clinical history of this uncommon condition before it progresses to critical limb ischemia when expeditious investigation and surgery are necessary to salvage the limb.

Cystic adventitial disease of the popliteal artery and of other stem vessels in the extremities.

Two hundred and thirty-four cases of cystic adventitial disease were collected from over two hundred world literatures and were classified into two groups: first, typical cystic adventitial disease of the popliteal artery, and second, that of the stem vessels in extremities other than the popliteal artery. The nomenclatures, clinical and pathological features, and etiology were reviewed. From the etiological point of view, the group in which the cyst was connected with joint capsule was identified as the joint group. All cases reported are listed in the two tables except those cases listed already in Flanigan's table.

Cystic adventitial disease of the popliteal artery.

In the 40 cases of cystic adventitial disease of the popliteal artery reported in the world literature, 20 patients have been treated by graft replacement with two of four synthetic graft failures and two of 14 vein-graft failures. Simple cyst evacuation has succeeded in all but two of 19 cases and reevaluation of cyst has succeeded in both of the evacuation failures. The condition causes severe calf claudication in young men, but does not progress to severe ischemia nor need for amputation, even with failure of arterial reconstruction. Etiology of the condition is obscure but may be related to cellular incorporation of mucin-secreting cells within the arterial adventitia.