1
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Flynn D, Tesar J, Peden S, Quinn S, Kruger A, Jenkins J. Venous cystic adventitial disease: to cure or manage? A case series. BMJ Case Rep 2022; 15:e247813. [PMID: 35027391 PMCID: PMC8762143 DOI: 10.1136/bcr-2021-247813] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/17/2021] [Indexed: 11/04/2022] Open
Abstract
Venous cystic adventitial disease is a rare vascular condition that can have significant effects on a patient's quality of life. The clinical presentation of venous cystic adventitial disease is variable, and there are no established guidelines on investigation or treatment of the disease. We present a series of three patients with venous cystic adventitial disease of the common femoral vein, treated within a single vascular surgery unit. Each of the three patients presented within 18 months of each other, despite the rarity of the disease. These are the only known cases treated within this vascular surgery unit. The investigation, management and treatment of each patient are individualised, with a management focus on quality of life.
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Affiliation(s)
- David Flynn
- Department of Vascular Surgery, Royal Brisbane and Women's Hospital, Brisbane, Queensland, Australia
| | - Joshua Tesar
- Department of Vascular Surgery, Royal Brisbane and Women's Hospital, Brisbane, Queensland, Australia
| | - Samantha Peden
- Department of Vascular Surgery, Royal Brisbane and Women's Hospital, Brisbane, Queensland, Australia
| | - Simon Quinn
- Department of Vascular Surgery, Royal Brisbane and Women's Hospital, Brisbane, Queensland, Australia
| | - Allan Kruger
- Department of Vascular Surgery, Royal Brisbane and Women's Hospital, Brisbane, Queensland, Australia
| | - Jason Jenkins
- Department of Vascular Surgery, Royal Brisbane and Women's Hospital, Brisbane, Queensland, Australia
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2
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Tan R, Tosenovsky P. Venous Adventitial Cyst Mimicking a Persistent Femoral Deep Venous Thrombosis. Ann Vasc Surg 2021; 73:511-514. [PMID: 33515660 DOI: 10.1016/j.avsg.2020.12.014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2020] [Revised: 11/13/2020] [Accepted: 12/01/2020] [Indexed: 11/29/2022]
Abstract
OBJECTIVE We describe the case of lower limb unilateral swelling due to a cystic mass (adventitial cystic disease) compressing on the common femoral vein. This was misdiagnosed as a deep vein thrombosis on both computed tomography venography and Doppler ultrasound. METHOD We describe the diagnostic pathways and surgical excision of this venous adventitial cyst of the femoral vein. CONCLUSION Venous adventitial cysts are a rare occurrence and diagnosis remains difficult. It often presents clinically as a Deep Vein Thrombosis (DVT). Suspicions should be raised should symptoms persist despite appropriate DVT management. Surgical management include endovascular, minimally invasive procedures, and complete evacuation of the mucoid cyst with excision of the cystic wall.
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Affiliation(s)
- Rebekah Tan
- Department of Vascular and Endovascular Surgery, Royal Perth Hospital, Perth, Australia.
| | - Patrik Tosenovsky
- Department of Vascular and Endovascular Surgery, Royal Perth Hospital, Perth, Australia
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3
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Mikhaylov IP, Lavrenov VN, Titova GP, Lepekhina IS. [Adventitial cyst of the popliteal artery]. Khirurgiia (Mosk) 2021:83-89. [PMID: 33395517 DOI: 10.17116/hirurgia202101183] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Vascular cystic adventitious degeneration (CAD) is a rare disease of unclear etiology that affects mainly the popliteal artery (up to 85-90% of cases). Clinical manifestations are similar to aneurysm of the popliteal artery. CAD occurs mainly in males of the 4th and 5th decades of life (range 10-77 years). These patients usually have no risk factors of cardiovascular diseases. Unilateral symptoms prevail. We report a review and a 46-year-old patient with CAD of the popliteal artery.
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Affiliation(s)
- I P Mikhaylov
- Sklifosovsky Research Institute for Emergency Care, Moscow, Russia
| | - V N Lavrenov
- Sklifosovsky Research Institute for Emergency Care, Moscow, Russia
| | - G P Titova
- Sklifosovsky Research Institute for Emergency Care, Moscow, Russia
| | - I S Lepekhina
- Sklifosovsky Research Institute for Emergency Care, Moscow, Russia
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4
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Min SH, Kim JH. Adventitial Cystic Disease of the Common Femoral Vein Mimicking Deep Venous Thrombosis: A Case Report. JOURNAL OF THE KOREAN SOCIETY OF RADIOLOGY 2021; 82:1315-1320. [PMID: 36238395 PMCID: PMC9432374 DOI: 10.3348/jksr.2020.0130] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/30/2020] [Revised: 09/23/2020] [Accepted: 01/11/2021] [Indexed: 11/15/2022]
Affiliation(s)
- Sun Ha Min
- Department of Radiology, Sanggye Paik Hospital, Inje University College of Medicine, Seoul, Korea
| | - Jae Hyung Kim
- Department of Radiology, Sanggye Paik Hospital, Inje University College of Medicine, Seoul, Korea
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Abstract
OBJECTIVES Cystic adventitial disease is an extremely rare vascular disorder and is often misdiagnosed. In order to improve the knowledge and treatment of this disease, a case of venous cystic adventitial disease was reported. METHODS The whole processes about the diagnosis and treatment of one patient with venous cystic adventitial disease was retrospectively studied. RESULTS This case of venous cystic adventitial disease was diagnosed accurately by contrast-enhanced computed tomography and treated successfully by surgical resection. No complications were detected after one-year post-operative follow-up. CONCLUSIONS Surgical resection is a safe and effective method for the treatment of venous CAD.
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Affiliation(s)
- Facai Guo
- Department of Vascular Surgery, Lanzhou University Second Hospital, Lanzhou, China
| | - Yi Guo
- Department of General Surgery, Chongqing University Central Hospital (Chongqing Emergency Medical Center), Chongqing, China
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6
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Yoshino S, Inoue K, Yoshiya K, Kurose S, Nakayama K, Morisaki K, Furuyama T, Matsumoto T, Oda Y, Mori M. Cystic Arterial Disease Located Only in the Media of the Popliteal Artery: A Case Report. Ann Vasc Dis 2019; 12:530-533. [PMID: 31942213 PMCID: PMC6957884 DOI: 10.3400/avd.cr.19-00057] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Adventitial cystic disease of the popliteal artery is a rare non-atheromatous peripheral artery disease. In most cases, the cystic lesion is located in the adventitia of the popliteal artery. Herein, we present a rare case of cystic arterial disease in which the cyst was located only in the media of the popliteal artery. We successfully treated the cyst with resection of the affected popliteal artery and reconstruction with an autogenous vein graft.
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Affiliation(s)
- Shinichiro Yoshino
- Department of Surgery and Science, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Fukuoka, Japan
| | - Kentaro Inoue
- Department of Surgery and Science, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Fukuoka, Japan
| | - Keiji Yoshiya
- Department of Surgery and Science, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Fukuoka, Japan
| | - Shun Kurose
- Department of Surgery and Science, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Fukuoka, Japan
| | - Ken Nakayama
- Department of Surgery and Science, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Fukuoka, Japan
| | - Koichi Morisaki
- Department of Surgery and Science, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Fukuoka, Japan
| | - Tadashi Furuyama
- Department of Surgery and Science, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Fukuoka, Japan
| | - Takuya Matsumoto
- Department of Surgery and Science, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Fukuoka, Japan.,Department of Vascular Surgery, Graduate School of Medical Sciences, International University of Health and Welfare, Narita, Chiba, Japan
| | - Yoshinao Oda
- Department of Anatomic Pathology, Pathological Sciences, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Fukuoka, Japan
| | - Masaki Mori
- Department of Surgery and Science, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Fukuoka, Japan
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7
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Howard E, Benson R, Day C, Gwynn B. Cystic adventitial disease of the common femoral vein. BMJ Case Rep 2017; 2017:bcr-2017-219818. [PMID: 28490479 DOI: 10.1136/bcr-2017-219818] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
We present the case of a 46-year-old commercial pilot with a history of unilateral leg swelling following a flight to Geneva. Although initial clinical examination suggested a deep vein thrombosis, the swelling only partially resolved with anticoagulation and further imaging suggested the presence of adventitial cystic disease (ACD). The patient underwent initial anticoagulation to allow any thrombus to be lysed, followed by excision of the ACD from the venous wall and venous reconstruction. Following the excision of the ACD, providing the patient remains asymptomatic and further imaging finds normal venous anatomy, we hope the patient will discontinue anticoagulation and return to flying.
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Affiliation(s)
- Emma Howard
- School of Medicine, Keele University, Keele, UK
| | - Ruth Benson
- Department of Vascular Surgery, University Hospitals of North Midlands NHS Trust, Stoke-on-Trent, Staffordshire, UK
| | - Christopher Day
- Department of Radiology, University Hospitals of North Midlands NHS Trust, Stoke-on-Trent, Staffordshire, UK
| | - Brian Gwynn
- Department of Vascular Surgery, University Hospitals of North Midlands NHS Trust, Stoke-on-Trent, Staffordshire, UK
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8
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Kim YK, Chun HJ, Hwang JK, Kim JI, Kim SD, Park SC, Moon IS. Adventitial cystic disease of the common femoral vein presenting as deep vein thrombosis. Asian J Surg 2016; 39:178-81. [DOI: 10.1016/j.asjsur.2013.07.002] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2012] [Revised: 11/15/2012] [Accepted: 07/09/2013] [Indexed: 11/29/2022] Open
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9
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Park SJ, Park WS, Min SY, Kwon SH, Park MS, Ahn HJ. Cystic adventitial disease of the common femoral artery at a previous surgical dissection site. Ann Vasc Surg 2014; 29:365.e1-3. [PMID: 25463335 DOI: 10.1016/j.avsg.2014.08.027] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2014] [Revised: 08/12/2014] [Accepted: 08/31/2014] [Indexed: 10/24/2022]
Abstract
Cystic adventitial disease (CAD) is a rare vascular disorder associated with nonatherosclerotic peripheral vessel disease and occurs when mucoid cysts in the adventitia compress the blood vessel. The underlying etiology and pathogenesis of CAD remain debatable as various theories have been suggested. This case is interesting because the cyst developed from the previous common femoral artery (CFA) dissection site. To our knowledge, this is the first report of CAD developed at a previous operation site. Thus, we report herein a case of CAD arising from a previous embolectomy dissection site in the CFA that was successfully treated with surgery.
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Affiliation(s)
- Sun Jin Park
- Department of Surgery, Kyung Hee University School of Medicine, Seoul, South Korea
| | - Won Seo Park
- Department of Surgery, Kyung Hee University School of Medicine, Seoul, South Korea
| | - Sun Young Min
- Department of Surgery, Kyung Hee University School of Medicine, Seoul, South Korea
| | - Se Hwan Kwon
- Department of Radiology, Kyung Hee University School of Medicine, Seoul, South Korea
| | - Min Soo Park
- Department of Surgery, Kyung Hee University School of Medicine, Seoul, South Korea
| | - Hyung Joon Ahn
- Department of Surgery, Kyung Hee University School of Medicine, Seoul, South Korea.
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10
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Patel SD, Guessoum M, Matheiken S. Cystic Adventitial Disease of the Common Femoral Artery Presenting with Acute Limb Ischemia. Ann Vasc Surg 2014; 28:1937.e9-1937.e11. [DOI: 10.1016/j.avsg.2014.07.020] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2014] [Revised: 06/29/2014] [Accepted: 07/13/2014] [Indexed: 10/24/2022]
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11
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Clinical Results of Cystic Excision for Popliteal Artery Cystic Adventitial Disease: Long-term Benefits of Preserving the Intact Intima. Ann Vasc Surg 2014; 28:1567.e5-8. [DOI: 10.1016/j.avsg.2014.01.016] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2013] [Revised: 12/31/2013] [Accepted: 01/28/2014] [Indexed: 11/18/2022]
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12
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Desy NM, Spinner RJ. The etiology and management of cystic adventitial disease. J Vasc Surg 2014; 60:235-45, 245.e1-11. [DOI: 10.1016/j.jvs.2014.04.014] [Citation(s) in RCA: 78] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2014] [Accepted: 04/06/2014] [Indexed: 12/20/2022]
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13
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Venous cystic adventitial disease of the common femoral vein. J Vasc Surg Venous Lymphat Disord 2014; 2:194-6. [DOI: 10.1016/j.jvsv.2013.07.002] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2013] [Revised: 06/24/2013] [Accepted: 07/09/2013] [Indexed: 11/21/2022]
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14
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Hao H, Ishibashi-Ueda H, Nishida N, Kawakami R, Tsukamoto Y, Tsujimoto M, Hirota S. Distribution of myofibroblast and tenascin-C in cystic adventitial disease: Comparison with ganglion. Pathol Int 2014; 63:591-8. [DOI: 10.1111/pin.12119] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2013] [Accepted: 11/14/2013] [Indexed: 02/01/2023]
Affiliation(s)
- Hiroyuki Hao
- Department of Surgical Pathology; Hyogo College of Medicine; Nishinomiya Hyogo Japan
| | - Hatsue Ishibashi-Ueda
- Department of Pathology; National Cerebral and Cardiovascular Center; Suita Osaka Japan
| | - Naoki Nishida
- Department of Pathology; National Cerebral and Cardiovascular Center; Suita Osaka Japan
| | - Rika Kawakami
- Department of Surgical Pathology; Hyogo College of Medicine; Nishinomiya Hyogo Japan
| | - Yoshitane Tsukamoto
- Department of Surgical Pathology; Hyogo College of Medicine; Nishinomiya Hyogo Japan
| | | | - Seiichi Hirota
- Department of Surgical Pathology; Hyogo College of Medicine; Nishinomiya Hyogo Japan
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15
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Kim SH, Lee CE, Park HO, Kim JW, Choi JY, Lee JH. Adventitial cystic disease of the common femoral artery: a case report and literature review. THE KOREAN JOURNAL OF THORACIC AND CARDIOVASCULAR SURGERY 2013; 46:150-2. [PMID: 23614104 PMCID: PMC3631792 DOI: 10.5090/kjtcs.2013.46.2.150] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/04/2012] [Revised: 10/18/2012] [Accepted: 10/18/2012] [Indexed: 11/28/2022]
Abstract
Arterial adventitial cystic disease is an uncommon type of non-atherosclerotic peripheral vessel disease. Most cases of arterial adventitial cystic disease occur in the popliteal arteries; however, fewer cases have been reported in the femoral arteries. A 59-year-old male patient visited the hospital with a complaint of a swelling on the lower extremity that had begun two months earlier. Suspecting deep vein thrombosis based on a physical examination and ultrasonography from another hospital, tests were performed. Magnetic resonance imaging (MRI) was performed for exact diagnosis because venous adventitial cystic disease was suspected by computed tomography venography. The MRI indicated venous adventitial cystic disease as well. Thus, a cystic mass excision was performed. In the end, a cystic mass compressing the common femoral vein that originated from the common femoral artery was diagnosed based on the macroscopic findings. This case is reported because blood circulation in the vein was impeded due to arterial adventitial cystic disease, and the symptoms improved after the cystic mass excision and polytetrafluoroethylene roofing angioplasty.
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Affiliation(s)
- Sung Hwan Kim
- Department of Thoracic and Cardiovascular Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Korea
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16
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In Treatment of Popliteal Artery Cystic Adventitial Disease, Primary Bypass Graft not Always First Choice: Two Case Reports and a Review of the Literature. Eur J Vasc Endovasc Surg 2011; 42:347-54. [DOI: 10.1016/j.ejvs.2011.03.003] [Citation(s) in RCA: 38] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2010] [Accepted: 03/07/2011] [Indexed: 11/24/2022]
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17
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Baxter AR, Garg K, Lamparello PJ, Mussa FF, Cayne NS, Berland T. Cystic adventitial disease of the popliteal artery: is there a consensus in management? Vascular 2011; 19:163-6. [DOI: 10.1258/vasc.2010.cr0233] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
Cystic adventitial disease (CAD) is a well described disease entity that commonly affects the popliteal artery, presenting as a rare cause of non-atherosclerotic claudication. The traditional surgical approaches are cyst resection and bypass, or cyst evacuation or aspiration. We report the case of a 58-year-old female with CAD of the popliteal artery treated successfully with cyst resection and bypass using an autologous graft. We reviewed the literature over the last 25 years on management and outcomes of CAD of the popliteal artery. We identified a total of 123 cases; most cases were treated using a traditional repair, while 3 cases used an endovascular approach. The overall success rate using bypass was 93.3%, compared to 85% in the evacuation/aspiration cohort. All cases treated endovascularly resulted in failure. While no consensus exists regarding the preferred modality to treat CAD, we believe that resection of the cyst and bypass affords the best outcomes.
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Affiliation(s)
- Andrew R Baxter
- Department of General Surgery, New York University Langone Medical Center
| | - Karan Garg
- Department of General Surgery, New York University Langone Medical Center
| | - Patrick J Lamparello
- Department of General Surgery, Division of Vascular Surgery, New York University Langone Medical Center, New York, NY, USA
| | - Firas F Mussa
- Department of General Surgery, Division of Vascular Surgery, New York University Langone Medical Center, New York, NY, USA
| | - Neal S Cayne
- Department of General Surgery, Division of Vascular Surgery, New York University Langone Medical Center, New York, NY, USA
| | - Todd Berland
- Department of General Surgery, Division of Vascular Surgery, New York University Langone Medical Center, New York, NY, USA
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18
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Dharmaraj R, Griffin J, Ramanathan A, Buckenham T. Case Report: Cystic Adventitial Disease of the External Iliac Artery with Imaging Features of a Complicating Proximal Dissection. ACTA ACUST UNITED AC 2011. [DOI: 10.1016/j.ejvsextra.2011.04.001] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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19
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Jayaraj A, Shalhub S, Deubner H, Starnes BW. Cystic Adventitial Disease of the Common Femoral Vein. Ann Vasc Surg 2011; 25:558.e9-11. [DOI: 10.1016/j.avsg.2010.10.016] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2010] [Accepted: 10/15/2010] [Indexed: 11/16/2022]
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20
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Rai S, Davies RS, Vohra RK. Failure of Endovascular Stenting for Popliteal Cystic Disease. Ann Vasc Surg 2009; 23:410.e1-5. [DOI: 10.1016/j.avsg.2008.01.014] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2007] [Revised: 11/26/2007] [Accepted: 01/03/2008] [Indexed: 11/25/2022]
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21
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Tomasian A, Lai C, Finn JP, Gelabert H, Krishnam MS. Cystic adventitial disease of the popliteal artery: features on 3T cardiovascular magnetic resonance. J Cardiovasc Magn Reson 2008; 10:38. [PMID: 18700041 PMCID: PMC2538522 DOI: 10.1186/1532-429x-10-38] [Citation(s) in RCA: 35] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2008] [Accepted: 08/13/2008] [Indexed: 11/16/2022] Open
Abstract
Cystic adventitial disease (CAD) of the popliteal artery is a rare vascular disease of unknown etiology in which a mucin-containing cyst develops in the adventitial layer of the artery. We report the case of a 26-year-old male with CAD of the right popliteal artery diagnosed non-invasively with 3 Tesla cardiovascular magnetic resonance and confirmed on post-operative histopathology.
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Affiliation(s)
- Anderanik Tomasian
- Department of Radiological Sciences, David Geffen School of Medicine, University of California, Los Angeles, CA, USA
| | - Chi Lai
- Department of Pathology, David Geffen School of Medicine, University of California, Los Angeles, CA, USA
| | - J Paul Finn
- Department of Radiological Sciences, David Geffen School of Medicine, University of California, Los Angeles, CA, USA
| | - Hugh Gelabert
- Department of Surgery, David Geffen School of Medicine, University of California, Los Angeles, CA, USA
| | - Mayil S Krishnam
- Department of Radiological Sciences, David Geffen School of Medicine, University of California, Los Angeles, CA, USA
- Suite 3371, Peter V. Ueberroth Bldg, 10945 Le Conte Ave, Los Angeles, CA, 90095-7206, USA
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22
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Tsilimparis N, Hanack U, Yousefi S, Alevizakos P, Rückert RI. Cystic adventitial disease of the popliteal artery: An argument for the developmental theory. J Vasc Surg 2007; 45:1249-52. [PMID: 17543690 DOI: 10.1016/j.jvs.2007.01.051] [Citation(s) in RCA: 51] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2006] [Accepted: 01/18/2007] [Indexed: 10/23/2022]
Abstract
Cystic adventitial disease is a rare non-atheromatous cause of popliteal artery disease. We report a case of a 54-year-old patient with claudication of the right calf caused by cystic adventitial disease. Intra-operatively, a communication between the adventitia and the knee joint was identified. Connections between the adventitial cyst and the nearby joint have been reported in the literature that support the developmental theory. This theory suggests that cystic adventitial disease is a developmental manifestation of mucin-secreting cells derived from the mesenchyme of the adjacent joint. This case is the first, to our knowledge, in which a communication between joint and adventitia has been clearly documented by operative findings.
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Affiliation(s)
- Nikolaos Tsilimparis
- Chirurgische Klinik/Gefässmedizin, Franziskus-Krankenhaus, Akademisches Lehrkrankenhaus der Charité-Universitätsmedizin, Berlin, Germany
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23
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Papas TT, Georgiadis GS, Maltezos CK, Lazarides MK. Adventitial cystic disease of the popliteal artery: a potential cause of intermittent claudication. Wien Klin Wochenschr 2007; 119:186-8. [PMID: 17427023 DOI: 10.1007/s00508-007-0772-9] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2006] [Accepted: 11/23/2006] [Indexed: 10/23/2022]
Abstract
Adventitial cystic disease (ACD) is an uncommon and rare vascular entity characterized by a highly viscous and mucinous cyst located in the adventitia of an artery. Although first described in the external iliac artery, the disease is more frequently sited in the popliteal artery. ACD characteristically occurs in young adults, mostly male, with intermittent claudication as the initial presenting symptom. As the cyst enlarges, it leads to vascular compression with stenosis or occlusion. Because cystic formation of the popliteal artery is uncommon, the disease is often unrecognized. We report a case of popliteal artery ACD in a 54-year-old woman who was successfully treated surgically.
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Affiliation(s)
- Theofanis T Papas
- Department of Vascular Surgery, Demokritos University Hospital, Alexandroupolis, Greece.
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25
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Dix FP, McDonald M, Obomighie J, Chalmers N, Thompson D, Benbow EW, Smyth JV. Cystic adventitial disease of the femoral vein presenting as deep vein thrombosis: A case report and review of the literature. J Vasc Surg 2006; 44:871-4. [PMID: 17012010 DOI: 10.1016/j.jvs.2006.05.034] [Citation(s) in RCA: 46] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2006] [Accepted: 05/19/2006] [Indexed: 11/23/2022]
Abstract
Cystic adventitial disease of veins is a rare condition. We report the case of a 28-year-old man who presented with a swollen leg secondary to obstruction of the common femoral vein as a result of this disease. He underwent excision of the cyst and made a full recovery. The presentation, investigation, treatment and pathology of this condition is discussed.
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Affiliation(s)
- Francis P Dix
- Department of Vascular Surgery, Manchester Royal Infirmary, Manchester, United Kingdom.
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