Adventitial cysts of the radial artery are joint connected

Abstract

Volar radial wrist masses are common. Adventitial cysts of the radial artery are rarely reported and poorly understood. We describe a case series of adventitial cysts in association with the radial artery and detail their pathophysiology and treatment. We conducted an Institutional Review Board-approved retrospective review of patients treated at our institution from 1997 to 2018. Twelve patients were identified. Presenting symptoms typically included pain and swelling over the volar radial wrist. High-resolution magnetic resonance imaging (MRI) demonstrated tubular, cystic lesions within the adventitia of the radial artery with connections to the wrist joint confirmed on multiplanar imaging: (radiocarpal joint = 10; scaphotrapeziotrapezoidal joint = 1; and intercarpal joint = 1). Seven patients underwent operation, at which time the cyst was resected and the articular branch disconnected. These patients reported resolution of their symptoms without clinical recurrence. The consistent finding of a joint connection in these cases of adventitial cysts associated with the radial artery has important clinical implications. The joint connection needs to be disconnected. Level of evidence: Level IV, case series. Clin. Anat., 2018. © 2018 Wiley Periodicals, Inc.

A novel mechanism for the formation and propagation of neural tumors and lesions through neural highways

“…Thus, it seemed logical that adventitial cysts in isolation, observed predominantly by vascular surgeons and which have been equally controversial and problematic, would be analogous to the intraneural cysts. We demonstrated that the unifying theory applies to adventitial cysts, including the popliiteal artery at the knee most commonly or the rarer radial artery at the wrist (Lewallen et al, 2019;Wang et al, 2007): a joint connection by a capsular vascular branch is the conduit for joint fluid to egress into the parent vessel (Desy & Spinner, 2014;Spinner et al, 2013). Based on this explanation, a paradigm shift has been proposed to treat adventitial cysts by disconnecting the vascular joint connection, which has already improved clinical outcomes and decreased recurrences (Desy & Spinner, 2014).…”