Cystic Adventitial Disease Of Popliteal Artery Research Articles

Successful surgical treatment of popliteal artery cystic adventitial disease

Successful surgical treatment of popliteal artery cystic adventitial disease

Popliteal artery cystic adventitial disease, a rare cause of intermittent claudication

Popliteal artery cystic adventitial disease, a rare cause of intermittent claudication

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.

Popliteal Artery Cystic Adventitial Disease: Early Lessons in Treatment

We present 6 patients who had operative repair of symptomatic popliteal cystic adventitial disease (pCAD). Developmental theories for pCAD and surgical alternatives are presented. All patients who had repair of pCAD over the past 3 years are included. Three patients had cyst excision alone, whereas the remaining 3 had cyst and artery excision with interposition vein grafting. Cyst recurrence occurred in 2 patients who had cyst excision alone. Four of the patients had a patent communication between the cyst and the joint capsule. Our small series suggests that the articular (synovial) theory of development may be the most likely and that cyst and artery excision with interposition vein grafting may be preferred over cyst excision alone.

Nonsurgical treatment of cystic adventitial disease of the popliteal artery caused by functional popliteal artery entrapment syndrome

Lower extremity claudication in young men can be caused by popliteal artery entrapment and vascular pathology. The case reported here describes a young male wrestler who presented with unilateral calf pain with activity. Imaging studies at rest demonstrated cystic adventitial disease of the popliteal artery. Stress imaging showed severe functional popliteal artery entrapment. This patient was treated with an imaging-guided botulinum toxin injection of the muscles at the site of arterial compression. The patient was asymptomatic 6 weeks after treatment. Repeat stress imaging demonstrated complete resolution of the entrapment and nearly complete resolution of the popliteal artery cystic adventitial disease.

Spontaneous Resolution of Cystic Adventitial Disease: A Word of Caution

Spontaneous resolution of cystic adventitial disease has been occasionally reported in the literature. It is unclear, however, whether this resolution is permanent. In this case report, we describe recurrence of a popliteal artery cystic adventitial disease after spontaneous resolution, which was successfully treated with surgery. The underlying mechanism is proposed. Without definitive treatment, the patients with spontaneous resolution of cystic adventitial disease may need long-term follow-up, given the risk of recurrence.

In Treatment of Popliteal Artery Cystic Adventitial Disease, Primary Bypass Graft not Always First Choice: Two Case Reports and a Review of the Literature

In Treatment of Popliteal Artery Cystic Adventitial Disease, Primary Bypass Graft not Always First Choice: Two Case Reports and a Review of the Literature

In Treatment of Popliteal Artery Cystic Adventitial Disease, Primary Bypass Graft not Always First Choice: Two Case Reports and a Review of the Literature

Cystic adventitial disease (CAD) is a rare cause of unilateral intermittent claudication of unknown aetiology, which is characterized by the formation of multiple mucin-filled cysts in the adventitial layer of the arterial wall resulting in obstruction to blood flow. The disease predominantly presents in young otherwise healthy males and most commonly affects the popliteal artery. CAD can be diagnosed by magnetic resonance imaging, computed tomographic angiography, or duplex ultrasound. Surgery is the primary mode of treatment, including exarterectomy, or replacement of the affected vascular segment by venous or synthetic interposition graft. Alternatively, the cysts can be drained by percutaneous ultrasound-guided needle aspiration. We provide a literature update on the aetiology and treatment of this uncommon condition and present two cases supporting patient tailored treatment without primary bypass grafting.

Interposition Grafting of Popliteal Artery Cystic Adventitial Disease: Case Report

Cystic adventitial disease of the popliteal artery is a rare cause of leg claudication occurring primarily in young adults. We report a case of a 41-year-old athletic man who presented with rapidly progressive left leg claudication. Using duplex ultrasound and magnetic resonance angiography, a diagnosis of popliteal artery cystic adventitial disease was made. The cystic popliteal artery was resected and replaced using a prosthetic interposition graft. At the 1.5-year follow-up, the cysts have recurred; however, the related symptoms have not. This is in contrast to a previously reported case of interposition saphenous vein grafting requiring resection due to invasion by recurrent cysts within 6 months.