Cystic Adventitial Disease Research Articles

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.

A Case of Adventitial Cystic Disease of the External Iliac Artery Developing Intermittent Claudication

A Case of Adventitial Cystic Disease of the External Iliac Artery Developing Intermittent Claudication

Early recurrence of cystic adventitial disease in a vein graft after complete resection of the popliteal artery

Case reportEarly recurrence of cystic adventitial disease in a vein graft after complete resection of the popliteal arteryIngo Flessenkaemper and Klaus-Michael MüllerIngo Flessenkaemper Department of Vascular Medicine, Helios Klinikum Emil von Behring, Berlin, Germany Search for more papers by this author and Klaus-Michael Müller Universitätskilinikum Münster, Germany Search for more papers by this authorPublished Online:January 15, 2014https://doi.org/10.1024/0301-1526/a000330PDF ToolsAdd to favoritesDownload CitationsTrack Citations ShareShare onFacebookTwitterLinkedInReddit SectionsMoreFiguresReferencesRelatedDetailsCited byZystische Adventitiadegeneration30 December 2021Inconsistent Use of Terminology and Different Treatment Outcomes of Venous Adventitial Cystic Disease: A Proposal for Reporting StandardsVascular Specialist International, Vol. 36, No. 2A case of cystic adventitial disease of the poplitealartery: selection of incision of the cyst wall overvessel replacementJournal of Rural Medicine, Vol. 15, No. 1Adventitial cystic disease of the radial artery14 May 2018 | Jornal Vascular Brasileiro, Vol. 17, No. 2Adventitial Cystic Disease of the Iliac Artery with a Connection to the Hip JointVascular Specialist International, Vol. 34, No. 1Adventitial cystic disease of radial artery. Apropos of a case and review of literatureCardiovascular Pathology, Vol. 29The etiology and management of cystic adventitial diseaseJournal of Vascular Surgery, Vol. 60, No. 1 Volume 43Issue 1January 2014ISSN: 0301-1526eISSN: 1664-2872 InformationVasa (2014), 43, pp. 69-72 https://doi.org/10.1024/0301-1526/a000330.© 2014Hogrefe AGPDF download

A contemporary review of venous adventitial cystic disease and three case reports

Venous adventitial cystic disease is a rare vascular disease. The objective of the study is to contemporarily review the literature of venous adventitial cystic disease and report three other new cases of adventitial cystic disease in common femoral vein. Articles published between 1947 and April 2013 were searched in OVID and PubMed databases. The search yielded only 38 reported cases of venous adventitial cystic disease. The general characteristics and disease management information of the 41 cases (including our current 3 cases) were analyzed. Venous adventitial cystic disease could develop late in life with an average age of 48.39 years (range, 5 to 77 years). Similar to arterial adventitial cystic disease, venous adventitial cystic disease was also found to have a male predominance (male to female ratio, 1.28:1). The common femoral vein was the most likely vein to be involved (65.9%, 27 cases). Right and left sides were almost equally affected. Extremity swelling (86.8%, 33 cases) was the main symptom of patients presenting with venous adventitial cystic disease. Excision of cyst wall in 30 patients (73.2%) was the main surgical procedure with a recurrence rate of 11.5%. Thirteen involved veins were resected; of which, 10 were reconstructed with prosthetic or autologous graft. No recurrence was reported in these 13 patients. Postoperatively, nine cases received an anticoagulation therapy. In conclusion, the etiology, treatment strategy, and outcomes of venous adventitial cystic disease could not be well understood in the present review due to limited numbers of cases. Studies with careful follow-up for at least up to first several months are recommended.

Distribution of myofibroblast and tenascin-C in cystic adventitial disease: Comparison with ganglion

Cystic adventitial disease (CAD) is a rare peripheral artery disorder which shows the development of gelatinous cysts in the adventitia. Although several theories for the pathogenesis of CAD have been postulated, the etiology of CAD remains unclear. Histological examination of three CAD cases revealed that these cyst walls were composed of fibrous tissue and lacked both epithelial and endothelial lining. The surfaces of these cysts were partially covered with spindle-shaped cells, similar to the interstitial cells within the cyst wall. A pool of mucinous material in the adventitia was evident. Distribution of vimentin-positive spindle-shaped cells and scattered CD68-positive oval-shaped cells in the cyst wall was revealed by immunohistochemistry. A part of vimentin-positive spindle-shaped cells demonstrated to be positive for α-smooth muscle actin, indicating the presence of myofibroblasts in the cyst wall. A focal tenascin-C-positive area was observed in the cyst wall of our CAD cases. Presence of two different cell types, proliferation of myofibroblasts and expression of tenascin-C were consistent with those of cyst walls of 20 surgically resected ganglions. These results suggest that CAD may arise as capsular synovial structures, similar to ganglion cysts.

Early Recurrence of Cystic Adventitial Disease Following Cyst Excision and Bypass Surgery

Early Recurrence of Cystic Adventitial Disease Following Cyst Excision and Bypass Surgery

Venous cystic adventitial disease of the common femoral vein.

Venous adventitial cystic disease is a rare condition with few reports previously described. We report the case of a 39-year-old female who presented with left lower extremity edema, acutely exacerbated by exercise. Imaging revealed a hypoechoic mass posterior to her left common femoral vein. Open surgical excision and evacuation was performed with resolution of symptoms within 24 hours. A review of the literature is discussed, along with presentation, diagnosis, treatment, and pathology of this intriguing condition.

Early Recurrence of Cystic Adventitial Disease Following Cyst Excision and Bypass Surgery

Cystic adventitial disease (CAD) is a rare progressive disease. No treatment guidelines exist. A female with CAD in the external iliac artery (EIA) previously treated with cyst excision and bypass, presented with relapse. The CAD had recurred and the bypass occluded. We performed en-mass resection of CAD, EIA, and occluded graft, followed by ilio-ilial interposition graft. Various treatment options for CAD have been published. Leaving the affected arterial segment in situ is associated with high risk of recurrence. Resection of CAD appears essential in light of the progressive nature of the disease.

Cystic Adventitial Disease of the Popliteal Artery Causing Intermittent Exertional Claudication in a Young Male Athlete

Cystic Adventitial Disease of the Popliteal Artery Causing Intermittent Exertional Claudication in a Young Male Athlete

Adventitial cystic disease of the common femoral vein presenting as deep vein thrombosis

Adventitial cystic disease of the common femoral vein is a rare condition. We herein report the case of a 50-year-old woman who presented with painless swelling in her left lower leg that resembled deep vein thrombosis. She underwent femoral exploration and excision of the cystic wall. The presentation, investigation, treatment, and pathology of this condition are discussed with a literature review.

Endovascular Treatment of Cystic Adventitial Disease of the Popliteal Artery

Cystic adventitial disease of the popliteal artery is an uncommon cause of intermittent claudication in young patients. Several treatment options are available, oriented to either drainage of the cyst and/or arterial reconstruction. Endovascular techniques have been used in exceptional cases to treat this condition, mostly balloon angioplasty and only 2 cases of stenting, with mixed to poor results. We report the case of a 36-year-old female patient with claudication who was treated with primary stenting with long-term symptomatic relief and arterial patency.

Cystic adventitial disease of the popliteal artery: report of two cases

Cystic adventitial disease (CAD) of the popliteal artery is a rare vascular disorder in which a mucin-containing cyst develops in the adventitial layer of the artery. We report two such cases, each of which was treated differently. The first case was of a 49-year-old man, treated by excision of the involved arterial segment and interposition of an autologous saphenous vein graft. The second case was of a 36-year-old man, treated by local excision of the affected arterial segment and interposition with prosthetic bypass grafting. Both patients presented with rapidly progressing intermittent claudication of the lower extremities, but without remarkable evidence of atherosclerotic disease. Physical examination revealed diminished or absent popliteal, posterior tibial and dorsalis pedis pulses in the lower extremities. Color Doppler ultrasound of the popliteal artery revealed hypoechoic cystic lesions surrounding the vessel, and popliteal arterial stenosis, in both patients. Surgery resulted in immediate improvement of the arterial pulse distal to the lesion. Both patients recovered uneventfully. Thus, resection of the involved artery segment and interposition bypass grafting, using either patient or prosthetic veins, offers favorable results for CAD of the popliteal artery.

Cystic Adventitial Disease of the Common Femoral Vein

We report on a 52-year-old female patient who presented with a 6-month history of right lower extremity swelling and tenderness. The patient was treated as an outpatient with full anticoagulation, without any improvement. Her medical history was significant for hypertension and high cholesterol, and she had a full coagulopathy profile that was negative for any hypercoagulable syndrome. On examination, the patient was moderately obese, with significant tenderness over the medial aspect of the right groin. A venous duplex examination revealed hypoechoic structure ± acute deep vein thrombosis of right common femoral vein (CFV). A computed tomography of the venous phase revealed an eccentric compression over the medial wall of the right CFV. During surgical exploration, adventitial cystic mucinous disease was enucleated from the medial wall of the right CFV, and the pathological examination confirmed the diagnosis. The postoperative course was uneventful, and all swelling and tenderness were completely resolved. The patient continued to do well, and she had an unremarkable venous duplex evaluation at her 6-month follow-up.

Two Cases of Adventitial Cystic Disease of the External Iliac Vein

Introduction: Adventitial cystic disease (ACD) affecting veins is a very rare condition. Report: We report two cases of ACD affecting veins in female patients aged 50 and 32 years who underwent surgical excision. Discussion: Venous ACD presents with deep venous thrombosis (DVT)-mimic symptoms resulting from venous compression by the cystic mass. Optimal treatment of venous ACD is complete surgical removal of the cystic wall and its contents; however, recurrent symptoms are often reported because of recurrence of the cystic mass. Two Cases of Adventitial Cystic Disease of the External Iliac VeinEJVES ExtraVol. 26Issue 3PreviewAdventitial cystic disease (ACD) affecting veins is a very rare condition. Full-Text PDF Open Access

Two Cases of Adventitial Cystic Disease of the External Iliac Vein

Adventitial cystic disease (ACD) affecting veins is a very rare condition. We report two cases of ACD affecting veins in female patients aged 50 and 32 years who underwent surgical excision. Venous ACD presents with deep venous thrombosis (DVT)-mimic symptoms resulting from venous compression by the cystic mass. Optimal treatment of venous ACD is complete surgical removal of the cystic wall and its contents; however, recurrent symptoms are often reported because of recurrence of the cystic mass.

High Spatial Resolution MRI of Cystic Adventitial Disease of the Iliofemoral Vein Communicating with the Hip Joint

Venous cystic adventitial disease (CAD) is an extremely rare entity, and so far less than 20 cases have been described in the literature. Herein, we describe the imaging findings of CAD of iliofemoral vein in a 51-year-old woman who presented with leg swelling with special emphasis on high spatial resolution MRI, which demonstrated communication of the cyst with the hip joint. To our knowledge, this is the first description of high spatial resolution MRI findings in venous CAD supporting a new theory about the pathogenesis of venous CAD.

Adventitial Cystic Disease of the Common Femoral Artery: A Case Report and Literature Review

Arterial adventitial cystic disease is an uncommon type of non-atherosclerotic peripheral vessel disease. Most cases of arterial adventitial cystic disease occur in the popliteal arteries; however, fewer cases have been reported in the femoral arteries. A 59-year-old male patient visited the hospital with a complaint of a swelling on the lower extremity that had begun two months earlier. Suspecting deep vein thrombosis based on a physical examination and ultrasonography from another hospital, tests were performed. Magnetic resonance imaging (MRI) was performed for exact diagnosis because venous adventitial cystic disease was suspected by computed tomography venography. The MRI indicated venous adventitial cystic disease as well. Thus, a cystic mass excision was performed. In the end, a cystic mass compressing the common femoral vein that originated from the common femoral artery was diagnosed based on the macroscopic findings. This case is reported because blood circulation in the vein was impeded due to arterial adventitial cystic disease, and the symptoms improved after the cystic mass excision and polytetrafluoroethylene roofing angioplasty.

Poplitealarterienaneurysma

Aneurysms of the popliteal artery are the most common form of peripheral aneurysm with an incidence of 70-80 %. An enlargement of the popliteal artery of more than 50% of the original diameter is defined as a popliteal artery aneurysm and is found mainly in male patients older than 65 years of age. The incidence is 1%, in 50% of cases is bilateral and in up to 50% in association with other large vessel aneurysms (e.g. abdominal aorta). Differential diagnoses are Baker's cyst, cystic adventitial disease, entrapment syndrome and epitheloid hemangioma. One third of all diagnosed popliteal artery aneurysms are asymptomatic incidental findings, whereas two thirds are conspicuous due to symptoms (acute or chronic ischemia, local compression, rupture). The indications for invasive treatment are given for patients with patent aneurysms at a diameter of more than 2 cm or if a thrombus is present within the aneurysm. Symptomatic popliteal artery aneurysms are always an indication for therapy. Treatment strategies are surgical techniques and endovascular interventions, which both have a similar outcome and graft patency in midterm results.

Resolution of cystic adventitial disease of the popliteal artery after unsuccessful treatment of percutaneous transluminal angioplasty

Resolution of cystic adventitial disease of the popliteal artery after unsuccessful treatment of percutaneous transluminal angioplasty