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Jing Z, Zhang C, Li X, Zhang H, Niu L, Feng Y, Liu Y, Yue Y, Du X, Luo X. Cystic Adventitial Disease of the Popliteal Vein: A Case Report. Vasc Endovascular Surg 2023; 57:164-168. [PMID: 36167456 DOI: 10.1177/15385744221130842] [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: 01/18/2023]
Abstract
Venous cystic adventitial disease (VCAD) is a rare vascular anomaly located in the common femoral vein in most cases. We describe the case of a 59-year-old female patient with right leg edema who was misdiagnosed with deep vein thrombosis of the lower extremity at another hospital. Magnetic resonance angiography revealed a round mass in the popliteal vein, with a narrow lumen. Considering the location of the lesion, absence of a history of deep venous thrombosis and trauma, and clinical manifestations, the diagnosis is likely a popliteal vein adventitial cyst. Segmental popliteal vein resection and reconstruction were performed using a cylindrical great saphenous vein graft. No joint connection was found during the operation, and the postoperative pathology confirmed VCAD.
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Affiliation(s)
- Zongxu Jing
- Department of Vascular Surgery, 117968Beijing Shijitan Hospital, Capital Medical University, Beijing, China
| | - Changming Zhang
- Department of Vascular Surgery, 117968Beijing Shijitan Hospital, Capital Medical University, Beijing, China
| | - Xiangtao Li
- Department of Vascular Surgery, 117968Beijing Shijitan Hospital, Capital Medical University, Beijing, China
| | - Huan Zhang
- Department of Vascular Surgery, 117968Beijing Shijitan Hospital, Capital Medical University, Beijing, China
| | - Luyuan Niu
- Department of Vascular Surgery, 117968Beijing Shijitan Hospital, Capital Medical University, Beijing, China
| | - Yaping Feng
- Department of Vascular Surgery, 117968Beijing Shijitan Hospital, Capital Medical University, Beijing, China
| | - Yong Liu
- Department of Ultrasound, Beijing Shijitan Hospital, Capital Medical University, Beijing, China
| | - Yunlong Yue
- Department of Magnetic Resonance, Beijing Shijitan Hospital, Capital Medical University, Beijing, China
| | - Xuemei Du
- Department of Pathology, Beijing Shijitan Hospital, Capital Medical University, Beijing, China
| | - Xiaoyun Luo
- Department of Vascular Surgery, 117968Beijing Shijitan Hospital, Capital Medical University, Beijing, China
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Biggs JH, Kalra M, Skinner JA, DeMartino RR. Adventitial cystic disease of the common femoral vein: an unusual cause of lower extremity swelling and review of the literature. JOURNAL OF VASCULAR SURGERY CASES INNOVATIONS AND TECHNIQUES 2021; 7:610-616. [PMID: 34746527 PMCID: PMC8551497 DOI: 10.1016/j.jvscit.2021.06.015] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/06/2021] [Accepted: 06/25/2021] [Indexed: 11/24/2022]
Abstract
We report the case of a 61-year-old man who had presented with acute unilateral limb swelling. Computed tomography venography and duplex ultrasound demonstrated compression of the right common femoral vein by a common femoral vein adventitial cyst. Before intervention, the patient had developed an acute deep vein thrombosis of the right common femoral vein and great saphenous vein. Preoperative magnetic resonance imaging demonstrated concern for synovial connection. After 6 months of anticoagulation therapy, the patient underwent adventitial cyst excision with ligation of the hip joint articular connection. At 4 months postoperatively, the patient was symptom free without cyst recurrence. The findings from the present case support the synovial theory for adventitial cystic disease.
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Affiliation(s)
- Joedd H Biggs
- Division of Vascular and Endovascular Surgery, Mayo Clinic, Rochester, Minn
| | - Manju Kalra
- Division of Vascular and Endovascular Surgery, Mayo Clinic, Rochester, Minn
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Yoo YS, Choi YD, Lee HK. Adventitial Cystic Disease of the Superficial Femoral Vein without a Joint Connection: A Case Report. Vasc Specialist Int 2021; 37:15. [PMID: 34168097 PMCID: PMC8236340 DOI: 10.5758/vsi.210034] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2021] [Revised: 06/11/2021] [Accepted: 06/17/2021] [Indexed: 11/20/2022] Open
Abstract
Adventitial cystic disease (ACD) of the veins is a rare vascular disease. Most cases of venous ACD are located adjacent to the joint area, such as the common femoral, external iliac, and popliteal veins. To the best of our knowledge, 67 cases of venous ACD have been reported, and ACD of the superficial femoral vein (SFV) has never been reported. Herein, we report the case of a 57-year-old male who presented with swelling and discomfort in the left leg. Computed tomography venography revealed multiple cystic lesions in the left distal SFV. The patient underwent cyst excision, which relieved the compression in the vein, although mild stenosis prevailed in the SFV. After a week, thrombosis developed in the popliteal vein. The thrombosis resolved after three months of anticoagulant therapy, and the patient showed no recurrence of ACD during three years of follow-up.
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Affiliation(s)
- Young Sup Yoo
- Department of Surgery, Chonnam National University Medical School, Gwangju, Korea
| | - Yoo Duk Choi
- Department of Pathology, Chonnam National University Medical School, Gwangju, Korea
| | - Ho Kyun Lee
- Department of Surgery, Chonnam National University Medical School, Gwangju, Korea
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Hashimoto M, Tamate Y, Sato H, Murakami A, Yanagawa N. Long-term outcome of partial resection in venous adventitial cystic disease. JOURNAL OF VASCULAR SURGERY CASES INNOVATIONS AND TECHNIQUES 2021; 7:382-385. [PMID: 34278063 PMCID: PMC8261535 DOI: 10.1016/j.jvscit.2021.04.022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/02/2021] [Accepted: 04/28/2021] [Indexed: 11/28/2022]
Abstract
Venous adventitial cystic disease is extremely rare. Therefore, standard treatment methods have not been clearly defined. Some reports suggest that complete cyst removal is an effective treatment. However, considering the relatively high recurrence rate, follow-up periods were short. Herein, we report the case of a 75-year-old man with venous adventitial cystic disease successfully treated with partial cyst wall excision. No recurrence was observed for 10 years postoperatively. This case suggests that complete cyst wall excision might not be necessary for the treatment of venous adventitial cystic disease.
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Affiliation(s)
- Munetaka Hashimoto
- Department of Vascular Surgery, Iwate Prefectural Isawa Hospital, Oshu, Iwate, Japan
| | - Yoshihisa Tamate
- Department of Vascular Surgery, Iwate Prefectural Isawa Hospital, Oshu, Iwate, Japan
| | - Hiroko Sato
- Department of Vascular Surgery, Iwate Prefectural Isawa Hospital, Oshu, Iwate, Japan
| | - Akihiko Murakami
- Department of Vascular Surgery, Iwate Prefectural Isawa Hospital, Oshu, Iwate, Japan
| | - Naoki Yanagawa
- Department of Molecular Diagnostic Pathology, Iwate Medical University School of Medicine, Morioka, Iwate, Japan
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Tinelli G, Montanari F, Minelli F, De Nigris F, Sica S, Tshomba Y. Long-term follow-up of adventitial cyst surgical excision in external iliac vein. JOURNAL OF VASCULAR SURGERY CASES INNOVATIONS AND TECHNIQUES 2020; 6:320-323. [PMID: 33367187 PMCID: PMC7748988 DOI: 10.1016/j.jvscit.2020.04.008] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/25/2020] [Accepted: 04/24/2020] [Indexed: 11/29/2022]
Abstract
Adventitial cystic disease of the venous system is an extremely rare condition. Forty-five cases have been described in the literature during the last 70 years, but they may not be representative of the real incidence of this pathologic process. We report a case of an adventitial cyst compressing the right external iliac vein and presenting with edema of the ipsilateral leg. Ultrasound imaging and computed tomography angiography showed the typical features of cystic disease and venous stenosis. Cyst excision was performed with a double surgical access. No perioperative complications were reported. There was no recurrence at 4-year follow-up.
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Affiliation(s)
- Giovanni Tinelli
- Correspondence: Giovanni Tinelli, MD, PhD, Chirurgia Vascolare, Polo CardioVascolare e Toracico, Fondazione Policlinico Universitario Gemelli IRCCS-Università Cattolica del Sacro Cuore, Largo Agostino Gemelli, 8, 00168 Rome, Italy
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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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Lun Y, Zhang J, Jiang H, Xu D, Sun J, Wang S, Xin S. Treatment Options for Venous Cystic Adventitial Disease: A Case Report and Literature Review. Ann Vasc Surg 2019; 64:413.e1-413.e4. [PMID: 31669477 DOI: 10.1016/j.avsg.2019.10.057] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2019] [Revised: 09/29/2019] [Accepted: 10/12/2019] [Indexed: 12/01/2022]
Abstract
Venous cystic adventitial disease (CAD) is an uncommon vascular anomaly that most frequently affects the common femoral vein. Transluminal or transadventitial evacuation followed by cyst excision is considered an effective treatment for this condition, although the recurrence rate is relatively high. Herein, we report a case of a 59-year-old man with venous CAD that was successfully treated with saphenous vein patch angioplasty after mucoid evacuation and cyst excision, and we discuss the options for treating venous CAD.
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Affiliation(s)
- Yu Lun
- Department of Vascular Surgery, The First Hospital, China Medical University, Shenyang, China
| | - Jian Zhang
- Department of Vascular Surgery, The First Hospital, China Medical University, Shenyang, China.
| | - Han Jiang
- Department of Vascular Surgery, The First Hospital, China Medical University, Shenyang, China
| | - Dongdong Xu
- Department of Vascular Surgery, The First Hospital, China Medical University, Shenyang, China
| | - Jianjian Sun
- Department of Vascular Surgery, The First Hospital, China Medical University, Shenyang, China
| | - Shiyue Wang
- Department of Vascular Surgery, The First Hospital, China Medical University, Shenyang, China
| | - Shijie Xin
- Department of Vascular Surgery, The First Hospital, China Medical University, Shenyang, China
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Rog CJ, French B, Kobayashi E, Tan SL. Cystic Adventitial Disease of the Common Femoral Vein Successfully Treated with Resection, Synthetic Graft Reconstruction, and Fistula Creation. Ann Vasc Surg 2019; 64:408.e1-408.e3. [PMID: 31634606 DOI: 10.1016/j.avsg.2019.09.029] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2019] [Revised: 07/27/2019] [Accepted: 09/19/2019] [Indexed: 10/25/2022]
Abstract
Cystic adventitial disease (CAD) is a rare, benign disease of blood vessels which most commonly affects the popliteal artery. Less than 50 cases of CAD affecting veins have ever been described in the literature to date. We report the case of a 56-year-old woman who presented with unilateral lower extremity swelling and varicosities due to CAD of her common femoral vein. Resection and reconstruction with a venous interposition graft, employing a polytetrafluoroethylene graft and arteriovenous fistula in order to maintain venous bypass patency, were performed successfully. The patient recovered well without any evidence of recurrence or postoperative complications.
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Liu P, Yan B, Zhang Y, Yan J, Ma C, Wang G, Jian T, Sun Z. Cystic adventitial disease of femoral vein presenting as enlarging lower limb swelling and pain: Two case reports and review of the literature. Exp Ther Med 2019; 18:3563-3567. [PMID: 31602233 PMCID: PMC6777217 DOI: 10.3892/etm.2019.7992] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2019] [Accepted: 08/05/2019] [Indexed: 11/26/2022] Open
Abstract
Cystic adventitial disease (CAD) is a condition that mainly affects the arterial system but rarely involves the venous system. The present study reported on two cases of CAD of femoral veins. The clinical manifestations in the two patients included pain and swelling of the lower limbs, but they had no risk factors for venous thrombosis. Color ultrasonography indicated cystic space-occupying lesions around the femoral veins, and enhanced computed tomography (CT) revealed vascular compression and space-occupying properties of the femoral veins. The two patients underwent open surgery, the postoperative treatment was uneventful, and swelling and tenderness were completely resolved. The pathological examination confirmed CAD of femoral vein in the two patients. The enhanced CT venography scan indicated patency of the femoral vein in the two patients following the operation. The circumferences of the two patients' lower limbs had returned to normal at the 2-month follow-up. A review of the literature was performed, and the presentation, diagnosis, treatment and pathology of this rare condition were discussed.
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Affiliation(s)
- Peng Liu
- Department of Vascular Surgery, Affiliated Hospital of Jining Medical University, Jining, Shandong 272029, P.R. China
| | - Bin Yan
- Intensive Care Unit of Vascular Surgery, Xuanwu Hospital of Capital Medical University, Beijing 100053, P.R. China
| | - Yanhui Zhang
- Department of Oncology, Affiliated Hospital of Jining Medical University, Jining, Shandong 272029, P.R. China
| | - Jingwei Yan
- Department of Vascular Surgery, Affiliated Hospital of Jining Medical University, Jining, Shandong 272029, P.R. China
| | - Chong Ma
- Department of Vascular Surgery, Affiliated Hospital of Jining Medical University, Jining, Shandong 272029, P.R. China
| | - Guodong Wang
- Department of Vascular Surgery, Affiliated Hospital of Jining Medical University, Jining, Shandong 272029, P.R. China
| | - Tao Jian
- Department of Vascular Surgery, Affiliated Hospital of Jining Medical University, Jining, Shandong 272029, P.R. China
| | - Ziqiang Sun
- Department of Vascular Surgery, Affiliated Hospital of Jining Medical University, Jining, Shandong 272029, P.R. China
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Venous Adventitial Cystic Disease: A Review of 45 Cases Treated Since 1963. Int J Vasc Med 2016; 2016:5287697. [PMID: 27885342 PMCID: PMC5112310 DOI: 10.1155/2016/5287697] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2016] [Accepted: 09/05/2016] [Indexed: 12/03/2022] Open
Abstract
Purpose. To review and identify the most accurate ways of diagnosing and treating adventitial cystic disease (ACD) of the venous system. Methods. Cases of ACD were collected through three popular medical databases, including PubMed, Cochrane, OVID, and MEDLINE. After reviewing the literature, the sites of occurrence of 323 cases of adventitial cystic disease were documented, and all cases of arterial ACD were excluded. The clinical features, treatment, and subsequent course of 45 cases of venous ACD are included in this paper. Results. After reviewing all 45 cases of venous ACD , we have confirmed that the most common vessel affected is the common femoral vein, which reproduces the most common symptom of venous ACD: asymmetric lower extremity swelling worsening over time. Conclusion. Venous ACD most commonly affects the common femoral vein. When unilateral leg swelling occurs with or without a noticeable mass, ACD should be considered. It is best confirmed with CT venography and the treatment of choice is transluminal cyst evacuation and excision.
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Marzo Álvarez A, Pobo Ruiz V, Carranza Martínez J, Soguero Valencia I, Rivera Rodríguez M. Enfermedad quística subadventicial en vena femoral común. ANGIOLOGIA 2016. [DOI: 10.1016/j.angio.2015.03.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
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Yu J, Lu C, Pan X, Li W. Cystic adventitial disease of the common femoral vein: A case report. Intractable Rare Dis Res 2016; 5:231-4. [PMID: 27672549 PMCID: PMC4995421 DOI: 10.5582/irdr.2016.01038] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
Adventitial cystic disease (ACD) of the common femoral vein is a rare vascular disorder. It becomes more difficult to recognize preoperatively especially when the femoral vein is affected. We report the case of a 62-year-old female patient who presented with a one-month history of painless swelling in her right lower extremity. She had no specific past medical history and no history of trauma, and had a full coagulopathy profile that was negative for any hypercoagulable syndrome. On examination, her lower right leg was significantly swollen with a palpable mass in her right inguinal region. A computerized tomography (CT) with contrast was performed to provide more information and revealed an eccentric compression over the medial wall of the right common femoral vein. During surgical exploration, adventitial cystic mucinous disease was enucleated and the patient underwent femoral exploration, excision of the cysts and reconstruction of iliac femoral vein graft using an artificial blood vessel. The pathological examination confirmed the diagnosis. The patient continued to do well, and she had an unremarkable venous duplex evaluation at her 6-month follow-up. The presentation, investigation, treatment, and pathology of this condition are discussed with a literature review.
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Affiliation(s)
- Jimei Yu
- Department of Operation, Huashan North Hospital, Fudan University, Shanghai China
| | - Chaojun Lu
- Department of Operation, Huashan North Hospital, Fudan University, Shanghai China
| | - Xiaohua Pan
- Department of Operation, Huashan North Hospital, Fudan University, Shanghai China
| | - Weihua Li
- Department of Operation, Huashan North Hospital, Fudan University, Shanghai China
- Address correspondence to: Dr. Weihua Li, Department of Operation, Huashan North Hospital, Fudan university, No. 108, Luxiang Road, Baoshan District, Shanghai 201907, China. E-mail:
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Vasconcelos RS, Cherubim CA, França FMP, D'allacqua EDL, Dalio MB, Joviliano EE. Doença cística da adventícia na veia basílica: relato de caso. J Vasc Bras 2016; 15:245-249. [PMID: 29930597 PMCID: PMC5829763 DOI: 10.1590/1677-5449.002616] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
A doença cística da adventícia é uma entidade rara que acomete principalmente a artéria poplítea. A ocorrência em veias é muito rara, e sua etiologia é desconhecida. Clinicamente, apresenta-se como isquemia, trombose ou dor a depender do território acometido. Apresentamos o caso de um paciente masculino jovem referindo nódulo no braço esquerdo. A angiorressonância magnética do membro mostrou lesão cística em contato com a veia basílica, com conteúdo homogêneo e sem realce pós-contraste. Foi realizada ressecção da lesão em bloco com o segmento venoso envolvido. O estudo anatomopatológico foi sugestivo de cisto de adventícia de veia basílica.
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Affiliation(s)
- Rafael Sampaio Vasconcelos
- Universidade de São Paulo - USP, Faculdade de Medicina de Ribeirão Preto, Hospital das Clínicas, Departamento de Cirurgia e Anatomia, Divisão de Cirurgia Vascular e Endovascular, Ribeirão Preto, SP, Brasil
| | - Cesar Augusto Cherubim
- Universidade de São Paulo - USP, Faculdade de Medicina de Ribeirão Preto, Hospital das Clínicas, Departamento de Cirurgia e Anatomia, Divisão de Cirurgia Vascular e Endovascular, Ribeirão Preto, SP, Brasil
| | - Felipe Mavignier Pereira França
- Universidade de São Paulo - USP, Faculdade de Medicina de Ribeirão Preto, Hospital das Clínicas, Departamento de Cirurgia e Anatomia, Divisão de Cirurgia Vascular e Endovascular, Ribeirão Preto, SP, Brasil
| | - Eduardo de Lucca D'allacqua
- Universidade de São Paulo - USP, Faculdade de Medicina de Ribeirão Preto, Hospital das Clínicas, Departamento de Cirurgia e Anatomia, Divisão de Cirurgia Vascular e Endovascular, Ribeirão Preto, SP, Brasil
| | - Marcelo Bellini Dalio
- Universidade de São Paulo - USP, Faculdade de Medicina de Ribeirão Preto, Hospital das Clínicas, Departamento de Cirurgia e Anatomia, Divisão de Cirurgia Vascular e Endovascular, Ribeirão Preto, SP, Brasil
| | - Edwaldo Edner Joviliano
- Universidade de São Paulo - USP, Faculdade de Medicina de Ribeirão Preto, Hospital das Clínicas, Departamento de Cirurgia e Anatomia, Divisão de Cirurgia Vascular e Endovascular, Ribeirão Preto, SP, Brasil
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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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