Adventitial cystic disease of the popliteal artery with intimal tear

Cystic adventitial disease of the popliteal artery: A case report with review of literature

“…Patients present with intermittent vascular claudication in 81 % of the cases, with a history of trauma reported in only 4 % of those [ 11 ]. Some complications reported include intimal tear and arterial thrombosis [ 12 , 13 ]. In our case, the patient had vascular claudication.…”

Cystic adventitial disease of the popliteal artery presenting with features of entrapment syndrome

“…The cysts are composed of an accumulation of mucinous fluid formed by proteoglycans, mucoproteins, mucopolysaccharides, hyaluronic acid, and hydroxyproline. 2,5,6,8 Ninety percent of cases of CAD are unilateral, with involvement of the popliteal artery. [2][3][4][5][6] Less commonly, the external iliac, femoral, radial, ulnar, brachial, and axillary arteries are implicated.…”

“…Various hypotheses exist regarding the etiology of CAD, with no single theory universally accepted. Recurrent trauma of the popliteal artery as the cause of detachment of the adventitia from the media leading to cyst formation 3,8 was discounted by the lack of associated trauma in the majority of cases of CAD. 3 It was hypothesized that the presence of mesenchymal cells in the adventitia during embryogenesis can lead to cyst formation.…”

“…[2][3][4][5][6]8,10 Surgical methods include interposition grafting of the diseased segment, which offers the best long-term patency and was done here, cyst excision, and circumferential resection of the diseased adventitia. [2][3][4][5][6]8,10 Imageguided cyst aspiration, using ultrasound examination or CT scans, is associated with a higher risk of recurrence. 5,9 However, reports exist of successful treatment of CAD with aspiration with good 5-year follow-up outcome.…”

“…Although the usual trend is for cysts to progress in size and increase the degree of stenosis, dissipation without intervention is possible. 8,10 Several reports document regression of cysts within 5 weeks after the onset of symptoms, with longer durations reaching 10 and 15 months. 10 Sustained surveillance is mandatory following regression owing to recurrence.…”