Cystic Adventitial Disease - A Three Cases Report
This study presents three cases of cystic adventitial disease, a rarely occurring vascular pathology that mainly affects the arteries. The nature of the disease consists in the occurrence of adventitial cysts filled with mucous, and leads towards vascular destruction and stenosis as well as limb ischemia. The popliteal artery is most often concerned in this etiology, and male patients predominate. However, the etiology of the disease remains unknown. One can observe a similar chemical content of adventitial and Baker's cysts, and their occurrence near the joints. Adventitial cystic disease may result in atypical intermittent claudication. This disease is characterized by the absence of pulse during flexion of the knee joint. Duplex color ultrasonography plays an important role in the diagnosis of the disease, as well as arteriogaphy, where one can observe hourglass or semilunar vascular lumen stenosis. Surgical management is the method of choice. This study presents three cases of cystic adventitial disease. Two cases concerned the popliteal artery and one the common femoral artery. All three patients were male with symptoms of lower limb ischemia. The three patients underwent surgical treatment and were diagnosed with cysts - localized intravascularly - that were constricting the vessels and filled with a jelly-like content. Two patients with significant lesions required surgical excision of the changed vascular fragment and bypass grafting. The third patient was subjected to local cyst excision. Percutaneous cystic content aspiration is also a method of treatment.
- Flanigan D, Burnham S, Goodreau J: Summary of cases of adventitial disease of the popliteal artery. Ann Surg 1979; 189: 165-75.[PubMed][Crossref]
- Ortiz M WR, Lopera JE, Gimenez CR, et al.: Bilateral adventitial cystic disease of the popliteal artery. Cardiovasc Intervent Radiol 2006; 29: 306.
- Vasudevan A, Halak M, Lee S, et al.: Cystic adventitial disease: a case report and literature review. ANZ J Surg 2005; 75: 1120-22.[Crossref][PubMed]
- Cassar K, Engeset J: Cystic adventitial diseaese: a trap for the unwary. Eur J Vasc Endovasc Surg 2005; 29: 93-96.[Crossref]
- Miller A, Salenius JP, Sacks BA, et al.: Noninvasive vasacular imaging in the diagnosis and treatment of adventitial cystic disease of the popliteal artery. Br Med J 1997; 26: 715-20.
- Lewis GJT, Douglas DM, Reid W, et al.: Cystic adventitial disease of the popliteal artery. Br Med J 1967; 3: 411-15.[PubMed][Crossref]
- Ni Mhuircheartaigh N, Kavanagh E, O'Donohoe M, et al.: Pseudo compartment syndrome of the calf in athlete secondary to cystic adventitial disease of the popliteal artery. Br J Sports Med 2005; 39: 638-72.
- Papavassiliou VG, Nasim A, Awad EM, et al.: Adventitial cystic disease of the popliteal artery: the diagnostic and treatment: a case report. J Cardiovasc Surg 2002; 43: 399-400.
- Levien LJ, Benn CA: Adventitial cystic disease: a unifying hypothesis. J Vasc Surg 1998; 28: 193-205.[Crossref][PubMed]
- Pursell R, Torrie EPH, Gibson M, et al.: Spontaneous and permanent resolution of cystic adventitial disease of the popliteal artery. J R Soc Med 2004; 97: 77-78.[Crossref]
- Nishibe M, Nishibe T, Yamashita T, et al.: Cystic adventitial disease of the popliteal artery: etiologic considerations. J Cardiovasc Surg 2002; 43: 573-74.[WoS]
- Wright LB, Matchett WJ, Cruz CP, et al.: Popliteal Artery Disease: Diagnosis and Treatment. RadioGraphics 2004; 24: 467-79.[PubMed][Crossref]
- Jones WT, Gray BH: Arteriographic evidence of pseudoocclusion of the popliteal artery. Catheter Cardiovasc Interv 2006; 68: 522-25.[Crossref]
- Rispoli P, Moniaci D, Zan S, et al.: Cystic adventitial disease of popliteal artery. Report of 1 case and review of the literature. J Cardiovasc Surg 2003; 44: 255-58.
- Gutowski P, Cnotliwy M: Torbiel tętnicy podkolanowej u młodego mężczyzny. Pol Przegl Chir 1998; 2: 196.
- Elias DA, White LM, Rubenstein JD, et al.: Clinical Evaluation and MR Imaging Features of popliteal artery entrapment and cystic adventitial disease. AJR 2003; 180: 627-32.[Crossref]
- Fox CJ, Rasmussen TE, O'Donnell SD: Cystic adventitial disease of the popliteal artery. J Vasc Surg 2004; 39: 1351.[PubMed][Crossref]