Early recurrence of cystic adventitial disease in a vein graft after complete resection of the popliteal artery

Han

et al. 2020

VSI

Adventitial cystic disease (ACD) is a very rare condition characterized by the accumulation of a cyst filled with gelatinous substance in the adventitia of a vessel adjacent to the joint area. The cyst usually compresses the vessel lumen, causing claudication or leg swelling. The disease usually affects the popliteal artery. However, several cases of venous ACDs particularly in the common femoral or external iliac vein have been reported. The definition, diagnosis, and optimal treatment of ACD remain controversial because of its rarity and the inconsistent use of terminology. The heterogeneity of the reported cases is more prominent in venous ACD. Herein, the accurate terminology of cysts correlated to the joint (synovial cyst, ganglion cyst, and adventitial cyst) and the pathogenesis, anatomy, and optimal therapy of venous ACD are discussed in detail to establish reporting standards for future studies.

Section: Treatment Of Cystic Diseases Around the Jointsmentioning

confidence: 86%

Section: Recommended Reporting Standards For Venous Acdmentioning

confidence: 99%

Inconsistent Use of Terminology and Different Treatment Outcomes of Venous Adventitial Cystic Disease: A Proposal for Reporting Standards

Han

et al. 2020

VSI

“…Removal of the cyst and artery should decrease the risk of recurrence in remnant mesenchymal cells. However, it should be noted that case reports on recurrence showed that new cyst developed from the vein graft 8,9) . In contrast, the study supporting the synovial theory insists that resection is the most recommended surgery 3) .…”

Section: Discussionmentioning

confidence: 98%

A case of cystic adventitial disease of the poplitealartery: selection of incision of the cyst wall overvessel replacement

Tanaka¹,

Shimada²,

Terada³

2020

J Rural Med

Cystic adventitial disease (CAD), a rare arterial disorder, can cause localized arterial stenosis or obstruction. A 55-year-old man presented with a 2-month history of left lower leg pain and paleness when bending the left knee. The patient was diagnosed with CAD of the left popliteal artery based on imaging examinations. Surgery was performed with the patient placed in the prone position using an S-shaped skin incision, and the left popliteal artery was exposed. A simple incision of the cyst wall was made. There was no sign of recurrence at 1 year postoperatively.

“…In cases of resectional methods for treatment, recurrence has also been reported in a few patients [ 11 ]. These cases can also be explained by unresected multiloculated cyst contents presented as in our case, or reaccumulation of cystic fluid around the treated artery from the remaining unligated connection to the nearby joint.…”

Section: Discussionmentioning

confidence: 99%

Adventitial Cystic Disease of the Iliac Artery with a Connection to the Hip Joint

Kim

Park

Hwang

et al. 2018

VSI

More than 700 adventitial cystic diseases (ACDs) have been reported in the literature, with most cases affecting the popliteal artery in young men. Here, we describe our treatment and etiologic consideration of a patient who presented with an ACD of the external iliac artery, known to be an extremely rare location. On preoperative imaging, the ACD had a connection to the nearby hip joint and was treated with resection of the affected segment, including ligation of the joint connection and interposition with a prosthetic graft. The pathogenesis of ACDs is not fully understood; however, we believe that joint connections are important in their development and treatment.