A Case of Cystic Adventitial Degeneration of the Left Popliteal Artery Diagnosed by Intravascular Ultrasound

Abstract

An 87-year-old male was admitted with intermittent claudication of the left calf. We performed lower extremity angiography, which revealed stenosis of the left popliteal artery. Intravascular ultrasound (IVUS) image correctly identified the cystic appearance of visualized extravascular hypodensity, causing extrinsic compression of the lumen. We diagnosed the condition as cystic adventitial degeneration (CAD) of the popliteal artery. We operated a resection of a cyst with the artery and replaced the autovein graft (saphenous vein). After surgery, the patient was free of symptoms. CAD is a rare disease; thus, our IVUS findings may provide unique diagnostic clues in patients with CAD.

Cystic Adventitial Disease of the Popliteal Artery: Radical Surgical Treatment After Several Failed Approaches. A Case Report and Review of the Literature

“…9,34,35 A complementary diagnostic invasive exam is represented by intravascular ultrasonography (IVUS) that can clearly distinguish atherosclerosis, hematoma, aneurysm, dissection from an extravascular cyst that compressed the vessel lumen. 36 Our patient underwent a DUS and a CTA as first-line diagnostic approaches during his stay in the Emergency Department. MRI may even be a better alternative since it can provide more accurate information about the cyst's anatomical relationships with the surrounding tissues.…”

Cystic adventitial disease of the common femoral vein: A case report

“…Firstline investigation should probably involve duplex ultrasound imaging, which is cheap, available in most centers, and noninvasive, to exclude aneurysms and synovial cysts and to localize the cyst to the vessel wall. Ultrasound imaging may show the presence of a typical, anechoic mass with a posterior acoustic window and may allow ultrasound-guided treatment (13,14). CT and magnetic resonance imaging (MRI) have also been advocated to localize the pathology to the vessel wall, exclude other pathologies (such as Baker's cyst), and allow guided drainage.6 MRI can reveal high-signalintensity cysts with extrinsic compression of the vessel lumen.…”