Spontaneous and Permanent Resolution of Cystic Adventitial Disease of the Popliteal Artery

Pursell, R; Torrie, E.P.H.; Gibson, Matthew; Galland, R. B.

doi:10.1177/014107680409700208

Cited by 35 publications

(20 citation statements)

References 6 publications

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“…In addition, stenting across joints is generally avoided. Though successful percutaneous transluminal angioplasty [6] and even spontaneous resolution of CAD has been reported [7], such experiences are limited and surgical resection is generally considered to be an acceptable treatment.…”

Section: Discussionmentioning

confidence: 99%

Cystic Adventitial Disease of the Popliteal Artery: Resection and Repair with Autologous Vein Patch

Maeng

Chang

Kim

2011

Korean J Thorac Cardiovasc Surg

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Cystic adventitial disease is rare, but it is one of the well-recognized causes of non-atherosclerotic arterial stenosis or obstruction. Despite one of its most common symptoms being chronic intermittent claudication, it may be misdiagnosed as arterial embolism when presented with acute ischemic symptoms. Surgical resection is recommended because of recurrence or a low success rate with aspiration or endovascular stent. We performed resection and repair with autologous vein patch for cystic adventitial disease of the popliteal artery of a 57-year-old man presenting with pain, pallor, and paresthesia, without any postoperative complications or recurrence.

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Section: Discussionmentioning

confidence: 99%

Cystic Adventitial Disease of the Popliteal Artery: Resection and Repair with Autologous Vein Patch

Maeng

Chang

Kim

2011

Korean J Thorac Cardiovasc Surg

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“…On the contrary, in the three included cases of spontaneous cyst resolution, recurrence was not observed during follow-up, leading to the success rate of 100 per cent [78][79][80] . Other such cases involving remission during follow-up were also reported 81 , even after 10 years recurrence was excluded in a symptom-free patient, so the authors called this case a spontaneous and permanent CAD resolution 72 . The possible mechanisms of spontaneous cyst resolution may include cyst rupture 16,59 or drainage into the joint space, which is supported by the arthroscopic 35 , intraoperative 5,8,11,22,[31][32][33]41 or MRA (ref.…”

Section: Treatment Of Cadmentioning

confidence: 97%

“…Although some authors did report satisfactory long-term (up to 30 years) results of both the resectional and non-resectional approaches 6,33,71 , they concerned experience with single cases. No large multi-centre trials exist to show the superiority of any of the treatment techniques 72 .…”

Section: Treatment Of Cadmentioning

confidence: 99%

Cystic Adventitial Disease of the Popliteal Artery: Report on Three Cases and Review of the Literature

Drác¹,

Köcher²,

Utíkal³

et al. 2011

Biomed Pap Med Fac Univ Palacky Olomouc Czech Repub

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“…This differentiates CAD from the popliteal entrapment syndrome, where the pulse would disappear with contraction of the gastrocnemius during active plantar flexion or passive dorsiflexion of the foot (15). Claudication symptoms in CAD can be transient and may resolve spontaneously (16).…”

Section: Clinical Presentationmentioning

confidence: 99%

Cystic adventitial disease—case series and review of literature

Li¹,

King²,

Velasco³

et al. 2017

Ann. Transl. Med.

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Cystic adventitial disease (CAD) is a rare vascular disorder that involves the arteries and rarely the veins, most commonly found in the popliteal artery of male patients. Etiology of CAD is uncertain and currently without a consensus agreement. Clinically, the most common presenting symptom is claudication.Diagnosis requires a strong clinical suspicion in patients with intermittent claudication, but without other risk factors for atherosclerotic disease. Angiography, ultrasound (US), computed tomography (CT) and magnetic resonance imaging (MRI) can all be used for diagnosis. Treatment of CAD can be done via surgical resection or percutaneous intervention such as aspiration. CAD can rarely recur after treatment. Case presentation Case 1A 54-year-old male who presented after an abnormal ultrasound (US) with Doppler exam at an outside institution with a 2 months history of new, progressive right leg claudication. His medical history is significant for hypertension and a maternal history of fatal abdominal aortic aneurysm rupture. The patient states a history of trauma to the right knee of uncertain nature. He denies illicit drug use but confirms a long history of cigarette smoking. Review of systems is otherwise negative. On physical examination, no swelling, varicose veins or stiffness in the right leg were identified. The right pedal pulses were palpable but greatly reduced. The left leg is unremarkable. The initial abnormal Doppler US performed at an outside institution (image not available) reported a 1.5 cm right popliteal artery aneurysm with a possible dissection within this aneurysm and luminal narrowing. An urgent computed tomography angiography (CTA) abdomen and pelvis with runoff was performed which demonstrated a cystic structure intimately associated with the right above-theknee popliteal artery, causing near complete occlusion (Figures 1,2) without evidence of dissection. A presumptive diagnosis of cystic adventitial disease (CAD) is made at this time, and the patient was taken to the operating room for definitive diagnosis and management. A posterior surgical approach was taken and a cyst in the wall of the right popliteal artery was identified. The cyst was entered with the evacuation of viscous, jelly-like amber material. The entire cyst wall was resected. There was strong distal popliteal artery pulse status post cystectomy. The patient had an unremarkable recovery. Follow up with Doppler US performed at 2 and 4 months post-cystectomy showed a normal right popliteal artery, without evidence of cyst recurrence. Case 2A 58-year-old male developed an acute onset of left lower extremity claudication and numbness. There were no resting pain, skin ulcerations or prior history of claudication symptoms. On physical examination, the patient's right lower extremity pulses were within normal limits. The left lower extremity pedal pulses were palpable but reduced, and became nonpalpable with left knee flexion (positive Ishikawa sign). A Doppler US demonstrated an anechoic lesion intimately associat...

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Spontaneous and Permanent Resolution of Cystic Adventitial Disease of the Popliteal Artery

Cited by 35 publications

References 6 publications

Cystic Adventitial Disease of the Popliteal Artery: Resection and Repair with Autologous Vein Patch

Cystic Adventitial Disease of the Popliteal Artery: Resection and Repair with Autologous Vein Patch

Cystic Adventitial Disease of the Popliteal Artery: Report on Three Cases and Review of the Literature

Cystic adventitial disease—case series and review of literature

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