Cystic adventitial arterial disease

Macfarlane, Robert; Livesey, Steven; Dunn, D. C.

doi:10.1002/bjs.1800740205

Cited by 11 publications

(5 citation statements)

References 20 publications

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“…Adventitial cystic disease of the popliteal artery is a rare disorder that can compromise arterial perfusion to the leg and it is one nonatherosclerotic cause of intermittent claudication. 1–3 Angiography may demonstrate the classic “scimitar” sign of an adventitial cyst, a smooth, well-defined, crescent-shaped filling defect. In some cases, the popliteal artery may occlude.…”

Section: Discussionmentioning

confidence: 99%

Case Study: Cystic Adventitial Disease of the Popliteal Artery

Shaw

Pizzo

Pevec

et al. 2007

Journal for Vascular Ultrasound

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Introduction —Adventitial cystic disease is an unusual cause of lower-extremity ischemia. It affects large arteries, typically where the artery is near a joint space, and the popliteal artery is most commonly involved. Methods —A 60-year-old man with venous insufficiency and prior deep vein thrombosis was referred for a lower-extremity venous evaluation. He had chronic degenerative joint disease, with bilateral knee osteoarthritis, but a history of exertional right calf pain was elicited. His right femoral and popliteal pulses were normal, but the posterior tibial pulse was diminished and the dorsal pedal artery pulse was absent. A lower-extremity duplex ultrasound examination was performed, including conventional and panoramic B-mode imaging, color Doppler and power Doppler imaging, and pulsed flow assessment. Results —Chronic deep and superficial venous thrombosis was identified in the right lower extremity. During the examination, the right popliteal artery was noted to be abnormal. Imaging showed the flow lumen in the popliteal artery to be visibly narrowed by more than 50%. Peak systolic velocities (PSV) in the proximal popliteal artery were 82 cm/sec, with a normal triphasic waveform, but the PSV increased to 221 cm/sec through the stenotic segment. The luminal narrowing was limited to an approximately 3 cm segment of the popliteal artery. There was no visible plaque or evidence of vascular calcification. The lumen appeared compressed by hypoechoic, septated cystic material. There was no flow within the well-visualized cystic structure. The findings were subsequently correlated with arteriography. Adventitial cystic disease of the popliteal artery was diagnosed. The patient underwent successful right popliteal artery cystectomy. Intra-operative and post-operative duplex evaluations demonstrated normal findings. Conclusion —Cystic adventitial disease is a rare disorder that can compromise arterial perfusion to the leg and it is one nonatherosclerotic cause of intermittent claudication. In some cases, the popliteal artery may occlude. Incidental arterial disease may be encountered frequently with lower extremity venous duplex scanning. With a careful examination by a thorough technologist, rare and interesting pathology, such as cystic adventitial disease, is possible.

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Section: Discussionmentioning

confidence: 99%

Case Study: Cystic Adventitial Disease of the Popliteal Artery

Shaw

Pizzo

Pevec

et al. 2007

Journal for Vascular Ultrasound

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“…Investigators have attributed the cysts to microtrauma [1,7], embryologic origin [9,10], or ganglion formation [4,11]. More recently, Inoue et al [4] demonstrated mucinous degeneration in the media, prompting the term cystic degeneration.…”

Section: Discussionmentioning

confidence: 99%

“…In approximately 85% of cases reported, CAD affects the popliteal artery [1,2]. Typically, duplex sonography and angiography are used to establish a diagnosis.…”

Section: Introductionmentioning

confidence: 99%

Intravascular ultrasound diagnosis of cystic adventitial degeneration of the popliteal artery: A case report

Collins

Morgan

2001

Cathet Cardio Intervent

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“…Cystic adventitial degeneration (CAD) is a rare disease but a serious claudication that causes vascular stenosis, usually in middle-aged men. 1 , 2 In ~85% of cases reported, CAD affects the popliteal artery. 1 , 2 Typically, duplex sonography, angiography, contrast-enhanced computed tomography, and magnetic resonance imaging (MRI) are used to establish a diagnosis.…”

Section: Introductionmentioning

confidence: 99%

“… 1 , 2 In ~85% of cases reported, CAD affects the popliteal artery. 1 , 2 Typically, duplex sonography, angiography, contrast-enhanced computed tomography, and magnetic resonance imaging (MRI) are used to establish a diagnosis. 3 , 4 Earlier studies on CAD are almost single case reports or small case series.…”

Section: Introductionmentioning

confidence: 99%

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

Niizeki¹,

Ishino²,

Kitahara³

et al. 2016

Clin Med Insights Case Rep

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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.

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Cystic adventitial arterial disease

Cited by 11 publications

References 20 publications

Case Study: Cystic Adventitial Disease of the Popliteal Artery

Case Study: Cystic Adventitial Disease of the Popliteal Artery

Intravascular ultrasound diagnosis of cystic adventitial degeneration of the popliteal artery: A case report

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

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