Limits...
Surgical Treatment of Cystic Adventitial Disease of the Popliteal Artery: Five Case Reports.

Igari K, Kudo T, Toyofuku T, Inoue Y - Case Rep Vasc Med (2015)

Bottom Line: The etiology of CAD is unclear; however, the direct communication between a cyst and a joint is presumed to be a cause.Although less invasive treatment modalities, including percutaneous cyst aspiration and percutaneous transluminal angioplasty, have been the subject of recent reports, these treatments have had a higher recurrence rate.Therefore, all of the CAPDA cases in the present series were treated surgically, which lead to good outcomes.

View Article: PubMed Central - PubMed

Affiliation: Division of Vascular and Endovascular Surgery, Department of Surgery, Tokyo Medical and Dental University, 1-5-45 Yushima, Bunkyo-ku, Tokyo 113-8519, Japan.

ABSTRACT
Cystic adventitial disease (CAD) is a rare cause of intermittent claudication and nonatherosclerotic conditions in middle-aged men without cardiovascular risk factors. The etiology of CAD is unclear; however, the direct communication between a cyst and a joint is presumed to be a cause. We herein report a case series of CAD of the popliteal artery (CADPA), in which patients were treated with surgical resection and vascular reconstruction. Although less invasive treatment modalities, including percutaneous cyst aspiration and percutaneous transluminal angioplasty, have been the subject of recent reports, these treatments have had a higher recurrence rate. Therefore, all of the CAPDA cases in the present series were treated surgically, which lead to good outcomes.

No MeSH data available.


Related in: MedlinePlus

Intraoperative findings show (a) the controlled affected popliteal artery (white arrow) and (b) the resection being performed with an interposition graft (white arrow). The patient's head was to the right.
© Copyright Policy - open-access
Related In: Results  -  Collection


getmorefigures.php?uid=PMC4539061&req=5

fig1: Intraoperative findings show (a) the controlled affected popliteal artery (white arrow) and (b) the resection being performed with an interposition graft (white arrow). The patient's head was to the right.

Mentions: A 47-year-old male presented with a sudden-onset pain in his left leg and was admitted to another hospital. Angiography showed a 90% stenosis of the left popliteal artery, and he was transferred to our hospital. On physical examination, his left popliteal and pedal pulses were diminished, and his ankle brachial pressure index (ABI) on the left side was 0.5. US and MRI showed a severe stenosis of the left popliteal artery, which was compressed by a cystic mass. He was therefore diagnosed with CADPA. We decided to perform a surgical resection of the affected popliteal artery with vascular reconstruction. Under general anesthesia, his right great saphenous vein was harvested, and he was positioned prone for a posterior approach. The affected popliteal artery, including the cyst, was exposed and resected (Figure 1(a)), with revascularization using a harvested autologous vein graft (Figure 1(b)). The patient's postoperative course was uneventful. His postoperative ABI increased to 0.8. The histopathological findings showed fibrin and clots within the mucoid gel in the adventitia of the arterial wall, with an intact intima and media.


Surgical Treatment of Cystic Adventitial Disease of the Popliteal Artery: Five Case Reports.

Igari K, Kudo T, Toyofuku T, Inoue Y - Case Rep Vasc Med (2015)

Intraoperative findings show (a) the controlled affected popliteal artery (white arrow) and (b) the resection being performed with an interposition graft (white arrow). The patient's head was to the right.
© Copyright Policy - open-access
Related In: Results  -  Collection

Show All Figures
getmorefigures.php?uid=PMC4539061&req=5

fig1: Intraoperative findings show (a) the controlled affected popliteal artery (white arrow) and (b) the resection being performed with an interposition graft (white arrow). The patient's head was to the right.
Mentions: A 47-year-old male presented with a sudden-onset pain in his left leg and was admitted to another hospital. Angiography showed a 90% stenosis of the left popliteal artery, and he was transferred to our hospital. On physical examination, his left popliteal and pedal pulses were diminished, and his ankle brachial pressure index (ABI) on the left side was 0.5. US and MRI showed a severe stenosis of the left popliteal artery, which was compressed by a cystic mass. He was therefore diagnosed with CADPA. We decided to perform a surgical resection of the affected popliteal artery with vascular reconstruction. Under general anesthesia, his right great saphenous vein was harvested, and he was positioned prone for a posterior approach. The affected popliteal artery, including the cyst, was exposed and resected (Figure 1(a)), with revascularization using a harvested autologous vein graft (Figure 1(b)). The patient's postoperative course was uneventful. His postoperative ABI increased to 0.8. The histopathological findings showed fibrin and clots within the mucoid gel in the adventitia of the arterial wall, with an intact intima and media.

Bottom Line: The etiology of CAD is unclear; however, the direct communication between a cyst and a joint is presumed to be a cause.Although less invasive treatment modalities, including percutaneous cyst aspiration and percutaneous transluminal angioplasty, have been the subject of recent reports, these treatments have had a higher recurrence rate.Therefore, all of the CAPDA cases in the present series were treated surgically, which lead to good outcomes.

View Article: PubMed Central - PubMed

Affiliation: Division of Vascular and Endovascular Surgery, Department of Surgery, Tokyo Medical and Dental University, 1-5-45 Yushima, Bunkyo-ku, Tokyo 113-8519, Japan.

ABSTRACT
Cystic adventitial disease (CAD) is a rare cause of intermittent claudication and nonatherosclerotic conditions in middle-aged men without cardiovascular risk factors. The etiology of CAD is unclear; however, the direct communication between a cyst and a joint is presumed to be a cause. We herein report a case series of CAD of the popliteal artery (CADPA), in which patients were treated with surgical resection and vascular reconstruction. Although less invasive treatment modalities, including percutaneous cyst aspiration and percutaneous transluminal angioplasty, have been the subject of recent reports, these treatments have had a higher recurrence rate. Therefore, all of the CAPDA cases in the present series were treated surgically, which lead to good outcomes.

No MeSH data available.


Related in: MedlinePlus