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Jheun A, Cutmore C, Lee K, Rajendran S. Cystic adventitial disease of the popliteal artery. ANZ J Surg 2023; 93:2535-2536. [PMID: 37209372 DOI: 10.1111/ans.18519] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2023] [Revised: 04/11/2023] [Accepted: 05/06/2023] [Indexed: 05/22/2023]
Affiliation(s)
- Angela Jheun
- Concord Clinical School, The University of Sydney, Sydney, New South Wales, Australia
| | - Carina Cutmore
- Concord Clinical School, The University of Sydney, Sydney, New South Wales, Australia
- Department of Vascular Surgery, Concord Repatriation General Hospital, Sydney, New South Wales, Australia
- Concord Institute of Academic Surgery, Concord Repatriation General Hospital, Sydney, New South Wales, Australia
| | - Kenneth Lee
- Anatomical Pathology, Concord Repatriation General Hospital, Sydney, New South Wales, Australia
- Department of Medicine, The University of Sydney Medical School, New South Wales, Sydney, Australia
| | - Saissan Rajendran
- Concord Clinical School, The University of Sydney, Sydney, New South Wales, Australia
- Department of Vascular Surgery, Concord Repatriation General Hospital, Sydney, New South Wales, Australia
- Concord Institute of Academic Surgery, Concord Repatriation General Hospital, Sydney, New South Wales, Australia
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2
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Stammler F, Wenzler M. [Rare cause of calf pain in a 56-year-old female patient: cystic adventitial degeneration of the popliteal artery]. Dtsch Med Wochenschr 2023; 148:242-245. [PMID: 36848887 DOI: 10.1055/a-1976-4185] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/01/2023]
Abstract
INTRODUCTION Cystic adventitial degeneration (CAD) is a rare vascular disease, affects mostly middle-aged men, and as a nonatherosclerotic disease, is an uncommon differential diagnosis of intermittent claudication. CASE HISTORY A 56-year-old female patient presented to our medical office because of unexplained right-sided calf pain that was not constantly load-dependent. The complaints fluctuated considerably with longer symptom-free intervals. EXAMINATION AND FINDINGS Clinically, the patient presented regular pulses, which were maintained even with provocative maneuvers such as plantar flexion and knee flexion. Duplex sonography showed cystic masses around the popliteal artery. On MRI examination, a tubular tortuous connection to the knee joint capsule also appeared to be visualizable. A diagnosis of cystic adventitial degeneration was made. THERAPY AND COURSE In the absence of constant impairment of walking performance with symptom-free intervals as well as morphological and functional signs of stenosis, interventional or surgical therapy was not desired by the patient. Short-term follow-up revealed stable clinical and sonomorphologic findings over an observation period of 6 months so far. DISCUSSION CAD should also be considered in female patients with atypical leg symptoms. There are no uniform treatment recommendations for CAD, which is why it is a challenge to select the optimal, usually interventional procedure. In patients with few symptoms and no critical ischemia, a conservative approach with close follow-up may be justified, as in our case report.
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Affiliation(s)
- Frank Stammler
- Praxis für Gefäßmedizin und Venenzentrum, Bad Wildbad, GERMANY
| | - Marion Wenzler
- Praxis für Gefäßmedizin und Venenzentrum, Bad Wildbad, GERMANY
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3
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Tesar J, Moult V, Quinn S. Non-atherosclerotic cause of claudication: cystic adventitial disease of the popliteal artery. ANZ J Surg 2021; 91:E796-E797. [PMID: 33969613 DOI: 10.1111/ans.16920] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2021] [Revised: 04/12/2021] [Accepted: 04/24/2021] [Indexed: 11/30/2022]
Affiliation(s)
- Joshua Tesar
- Vascular Department, Royal Brisbane and Women's Hospital, Brisbane, Queensland, Australia
| | - Vivienne Moult
- Vascular Department, Royal Brisbane and Women's Hospital, Brisbane, Queensland, Australia
| | - Simon Quinn
- Vascular Department, Royal Brisbane and Women's Hospital, Brisbane, Queensland, Australia
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4
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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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5
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Schultz T. Ultrasound finding of cystic adventitial disease of the popliteal artery—A rare diagnosis for claudication. SONOGRAPHY 2020. [DOI: 10.1002/sono.12241] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
Affiliation(s)
- Teena Schultz
- The Vascular Institute, Bella Vista New South Wales Australia
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6
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Klaudikace u mladých pacientů. COR ET VASA 2020. [DOI: 10.33678/cor.2020.071] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
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7
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Esposito D, Masciello F, Dorigo W, Alessi Innocenti A, Santi R, Nesi G, Pratesi C. An unexpected intraoperative finding of cystic adventitial degeneration of the common femoral artery. J Surg Case Rep 2020; 2020:rjaa200. [PMID: 32821365 PMCID: PMC7427030 DOI: 10.1093/jscr/rjaa200] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2020] [Accepted: 05/29/2020] [Indexed: 11/13/2022] Open
Abstract
Herein we present a rare case of cystic adventitial degeneration involving the common femoral artery (CFA) of a 71-year-old patient, an unusual site of presentation of the disease. The most commonly affected district is the popliteal artery, and only a few cases of CFA involvement are described in literature. The history and comorbidities of the patient oriented us initially towards the diagnosis of an atherosclerotic obstructive disease. It was only intraoperatively indeed that a diagnosis of cystic adventitial arterial degeneration was made, subsequently confirmed by microscopic examination. Our case shows how both clinical and instrumental diagnosis of cystic adventitial disease can be challenging, given its non-specific presentation and low incidence. Suspicion of cystic adventitial degeneration is recommended in patients with sudden appearance of symptoms and with an isolated lesion of the affected artery without other involvement of the vascular tree.
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Affiliation(s)
- Davide Esposito
- Vascular Surgery Department, Careggi University Hospital, 50134, Florence, Italy
| | - Fabrizio Masciello
- Vascular Surgery Department, Careggi University Hospital, 50134, Florence, Italy
| | - Walter Dorigo
- Vascular Surgery Department, Careggi University Hospital, 50134, Florence, Italy
| | | | - Raffaella Santi
- Pathological Anatomy Unit, Careggi University Hospital, 50134, Florence, Italy
| | - Gabriella Nesi
- Pathological Anatomy Unit, Careggi University Hospital, 50134, Florence, Italy
| | - Carlo Pratesi
- Vascular Surgery Department, Careggi University Hospital, 50134, Florence, Italy
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Vaughn NH, Flemming DJ, Newell JM, Payatakes AH. Adventitial Cystic Disease of the Radial Artery. J Hand Surg Asian Pac Vol 2018; 23:581-584. [PMID: 30428811 DOI: 10.1142/s2424835518720347] [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: 11/18/2022]
Abstract
Upper extremity adventitial cystic disease is rare, but the characteristic findings of this lesion should be known to the hand surgeon and used to guide treatment. We present a case of a young adult male who developed a painless mass in his distal forearm. Diagnostic imaging workup revealed a cystic mass that extended within and encased the radial artery. Both MRI and direct intraoperative visualization confirmed the presence of a stalk connecting the intra-mural radial artery mass to the radiocarpal joint. The mass and stalk were excised en bloc with fenestration of the volar capsule to prevent recurrence. This case demonstrates a less common example of upper extremity adventitial cystic disease and supports the articular theory of origin of these lesions. When surgical excision is performed, an attempt should be made to identify and excise the articular stalk in an effort to minimize risk of recurrence.
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Affiliation(s)
- Natalie H Vaughn
- * Departments of Orthopaedics and Rehabilitation, Penn State College of Medicine, Milton S. Hershey Medical Center, Hershey, Pennsylvania, USA
| | - Donald J Flemming
- † Departments of Radiology, Penn State College of Medicine, Milton S. Hershey Medical Center, Hershey, Pennsylvania, USA
| | - Jordan M Newell
- ‡ Departments of Anatomic Pathology, Penn State College of Medicine, Milton S. Hershey Medical Center, Hershey, Pennsylvania, USA
| | - Alexander H Payatakes
- * Departments of Orthopaedics and Rehabilitation, Penn State College of Medicine, Milton S. Hershey Medical Center, Hershey, Pennsylvania, USA
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9
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Lee DJ, Park HO, Jang HN, Kim KN, Yang JH, Moon SH, Byun JH, Kim SH, Choi JY, Jang IS, Kim JW, Lee CE. A Report of Two Cases of Adventitial Cystic Disease of the Popliteal Artery. Knee Surg Relat Res 2018; 30:167-170. [PMID: 29715714 PMCID: PMC5990233 DOI: 10.5792/ksrr.17.058] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/28/2017] [Revised: 10/06/2017] [Accepted: 10/07/2017] [Indexed: 12/02/2022] Open
Abstract
Two patients were admitted to our department because of recent aggravation of claudication in the leg, which was exacerbated by walking. They were diagnosed as having a Baker cyst or acute thrombosis in the popliteal fossa at another hospital. There was no evidence of ischemia, and the ankle brachial index was normal. Computed tomography and magnetic resonance imaging were performed, revealing a cystic mass of the popliteal artery (PA). Intraoperatively, the cystic lesion was found within the adventitia of the PA; based on the biopsy findings, both patients were diagnosed as having adventitial cystic disease of the PA.
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Affiliation(s)
- Doo Jae Lee
- Division of Foot and Ankle, Department of Orthopedic Surgery, Seoul National University Hospital, Seoul, Korea
| | - Hyun Oh Park
- Department of Thoracic and Cardiovascular Surgery, Gyeongsang National University Changwon Hospital, Gyeongsang National University College of Medicine, Changwon, Korea
| | - Ha Nee Jang
- Department of Internal Medicine, Gyeongsang National University Hospital, Gyeongsang National University College of Medicine, Jinju, Korea
| | - Ki Nyun Kim
- Department of Thoracic and Cardiovascular Surgery, Gyeongsang National University Changwon Hospital, Gyeongsang National University College of Medicine, Changwon, Korea
| | - Jun Ho Yang
- Department of Thoracic and Cardiovascular Surgery, Gyeongsang National University Hospital, Gyeongsang National University College of Medicine, Jinju, Korea
| | - Seong Ho Moon
- Department of Thoracic and Cardiovascular Surgery, Gyeongsang National University Changwon Hospital, Gyeongsang National University College of Medicine, Changwon, Korea
| | - Joung Hun Byun
- Department of Thoracic and Cardiovascular Surgery, Gyeongsang National University Changwon Hospital, Gyeongsang National University College of Medicine, Changwon, Korea
| | - Sung Hwan Kim
- Department of Thoracic and Cardiovascular Surgery, Gyeongsang National University Changwon Hospital, Gyeongsang National University College of Medicine, Changwon, Korea
| | - Jun Young Choi
- Department of Thoracic and Cardiovascular Surgery, Gyeongsang National University Hospital, Gyeongsang National University College of Medicine, Jinju, Korea
| | - In Seok Jang
- Department of Thoracic and Cardiovascular Surgery, Gyeongsang National University Hospital, Gyeongsang National University College of Medicine, Jinju, Korea
| | - Jong Woo Kim
- Department of Thoracic and Cardiovascular Surgery, Gyeongsang National University Changwon Hospital, Gyeongsang National University College of Medicine, Changwon, Korea
| | - Chung Eun Lee
- Department of Thoracic and Cardiovascular Surgery, Gyeongsang National University Changwon Hospital, Gyeongsang National University College of Medicine, Changwon, Korea
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Oliveira JCPD, Barreto FTR, Souza DDBDAE, Fonseca JMFE, Chimelli BDCAR, Peclat APRM, Marques MA, Fiorelli SKA. Doença cística adventicial da artéria poplítea: relato de caso. J Vasc Bras 2018; 17:55-60. [PMID: 29930682 PMCID: PMC5990258 DOI: 10.1590/1677-5449.009217] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
A doença cística adventicial da artéria poplítea é uma doença pouco frequente, que deve ser considerada no diagnóstico diferencial de pacientes jovens com claudicação intermitente e sem fatores de risco para doença arterial periférica aterosclerótica. Apresentamos um caso de claudicação intermitente de membros inferiores em paciente masculino de 51 anos no qual essa doença foi diagnosticada. Foi submetido a ressecção do segmento de artéria comprometido e interposição de safena autóloga ipsilateral. Discutimos alternativas diagnósticas e terapêuticas.
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11
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Uncommon Diseases of The Popliteal Artery: A Pictorial Review. Insights Imaging 2016; 7:679-88. [PMID: 27525419 PMCID: PMC5028342 DOI: 10.1007/s13244-016-0513-6] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2016] [Revised: 07/06/2016] [Accepted: 07/19/2016] [Indexed: 12/19/2022] Open
Abstract
Uncommon diseases of the popliteal artery include cystic adventitial disease, popliteal artery entrapment syndrome (PAES) and popliteal artery aneurysm (PAA). Because all of these conditions may present with pain or intermittent claudication, imaging is crucial for differentiating them and directing management. Delayed diagnosis can lead to major complications, including acute limb ischemia. Our aim is to provide an illustrative overview of these conditions in order to make radiologists aware of them and avoid misdiagnosis for timely appropriate management. Teaching Points • Cystic adventitial disease diagnosis is based on evidence of cysts within artery walls. • A variety of anatomic variations may result in PAES. • PAES may be bilateral. • PAA is most commonly encountered in men. • Acute complications of PAA include acute thrombosis and distal embolization.
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12
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Abid A, Kelley JF, Flemming DJ, Silvis ML. A young male runner with a posterior knee mass--not just your typical Baker's cyst. BMJ Case Rep 2016; 2016:bcr-2015-213750. [PMID: 26933185 DOI: 10.1136/bcr-2015-213750] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
We present the case of a 28-year-old man with a growing mass in his right popliteal fossa causing pain on exertion. The differential diagnosis included Baker's cyst, entrapment syndrome of the popliteal artery, as well as a benign or malignant neoplasm. An ultrasound was non-specific. Follow-up MRI of the knee demonstrated cystic adventitial disease (CAD). With only about 500 cases reported in the literature since its discovery in 1947, CAD is a rare entity. The disease is characterised by mucinous or gelatinous cysts in the arterial or venous adventitia. The disease is predominantly seen in the popliteal artery and typically affects otherwise healthy males in the fourth to fifth decade of life. It presents clinically as intermittent exertional claudication. Examination of our case and a review of the literature will highlight the importance of considering CAD in patients who report of a popliteal mass and intermittent claudication.
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Affiliation(s)
- Ayesha Abid
- Department of Family and Community Medicine, Penn State Milton S Hershey Medical Center, Hershey, Pennsylvania, USA Department of Radiology, Penn State Milton S Hershey Medical Center, Hershey, Pennsylvania, USA
| | - James Fitzhugh Kelley
- Department of Family and Community Medicine, Penn State Milton S Hershey Medical Center, Hershey, Pennsylvania, USA
| | - Donald J Flemming
- Department of Radiology, Penn State Milton S Hershey Medical Center, Hershey, Pennsylvania, USA
| | - Matthew L Silvis
- Department of Family and Community Medicine, Penn State Milton S Hershey Medical Center, Hershey, Pennsylvania, USA Department of Orthopedics and Rehabilitation, Penn State Milton S Hershey Medical Center, Hershey, Pennsylvania, USA
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13
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Takasawa Y, Mizuno S, Maekawa N, Yamaguchi J, Suzuki M, Tsuchida M, Saga M, Kokado H, Misawa K, Murakami T, Moriuchi I, Ohsato K. Diagnosis of adventitial cystic disease of the popliteal artery by optical coherence tomography. Int J Cardiol 2016; 203:653-5. [PMID: 26580350 DOI: 10.1016/j.ijcard.2015.10.229] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/27/2015] [Accepted: 10/30/2015] [Indexed: 10/22/2022]
Affiliation(s)
- Yosuke Takasawa
- Division of Cardiovascular Medicine, Fukui Cardiovascular Center.
| | - Sumio Mizuno
- Division of Cardiovascular Medicine, Fukui Cardiovascular Center
| | - Naoto Maekawa
- Division of Cardiovascular Medicine, Fukui Cardiovascular Center
| | - Junya Yamaguchi
- Division of Cardiovascular Medicine, Fukui Cardiovascular Center
| | - Masatomo Suzuki
- Division of Cardiovascular Medicine, Fukui Cardiovascular Center
| | | | - Makoto Saga
- Division of Cardiovascular Medicine, Fukui Cardiovascular Center
| | - Hiromasa Kokado
- Division of Cardiovascular Medicine, Fukui Cardiovascular Center
| | - Katsushi Misawa
- Division of Cardiovascular Medicine, Fukui Cardiovascular Center
| | | | - Ikuo Moriuchi
- Division of Cardiovascular Medicine, Fukui Cardiovascular Center
| | - Kazuo Ohsato
- Division of Cardiovascular Medicine, Fukui Cardiovascular Center
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14
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Abstract
Cystic adventitial disease of the popliteal artery is a relatively rare entity, responsible for approximately 1 in 1,200 cases of claudication. We present a case with both classic history and imaging features. We hope that our experiences may increase radiologists’ familiarity with this unusual but treatable entity.
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15
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Chen CH, Wen JS, Wang CK. Huge pseudoaneurysm and cystic adventitial disease from popliteal artery entrapment. Circulation 2015; 132:1284-5. [PMID: 26416631 DOI: 10.1161/circulationaha.115.018399] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Affiliation(s)
- Chia-Hui Chen
- From Department of Medical Imaging and Radiological Sciences, Central Taiwan University of Science and Technology, Taichung, Taiwan (C.-H.C.); and Department of Surgery (J.-S.W.) and Department of Radiology (C.-K.W.), National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan
| | - Jih-Sheng Wen
- From Department of Medical Imaging and Radiological Sciences, Central Taiwan University of Science and Technology, Taichung, Taiwan (C.-H.C.); and Department of Surgery (J.-S.W.) and Department of Radiology (C.-K.W.), National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan
| | - Chien-Kuo Wang
- From Department of Medical Imaging and Radiological Sciences, Central Taiwan University of Science and Technology, Taichung, Taiwan (C.-H.C.); and Department of Surgery (J.-S.W.) and Department of Radiology (C.-K.W.), National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan.
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17
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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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18
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Spinner RJ, Desy NM, Agarwal G, Pawlina W, Kalra M, Amrami KK. Evidence to support that adventitial cysts, analogous to intraneural ganglion cysts, are also joint-connected. Clin Anat 2012; 26:267-81. [DOI: 10.1002/ca.22152] [Citation(s) in RCA: 51] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2012] [Accepted: 07/26/2012] [Indexed: 11/09/2022]
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19
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Kawarai SI, Fukasawa M, Kawahara Y. Adventitial cystic disease of the popliteal artery. Ann Vasc Dis 2012; 5:190-3. [PMID: 23555509 DOI: 10.3400/avd.cr.11.00069] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2011] [Accepted: 01/21/2012] [Indexed: 11/13/2022] Open
Abstract
We describe a patient with adventitial cystic disease of the popliteal artery with intermittent claudication involving the right calf during exercise. Magnetic resonance imaging (MRI) and computed tomography (CT) revealed a cystic lesion that encircled and compressed the popliteal artery. Resection of the cyst involving a segment of the affected popliteal artery and interposing an autologous vein graft resolved the symptoms, and the postoperative course was uneventful. The cyst was histologically similar to a ganglion.
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Affiliation(s)
- Shun-Ichi Kawarai
- Department of Cardiovascular Surgery, Hachinohe City Hospital, Hachinohe, Aomori, Japan
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20
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Paravastu SCV, Regi JM, Turner DR, Gaines PA. A Contemporary Review of Cystic Adventitial Disease. Vasc Endovascular Surg 2011; 46:5-14. [DOI: 10.1177/1538574411419377] [Citation(s) in RCA: 55] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Cystic adventitial disease (CAD) is a rare vascular disorder, predominantly seen in young healthy men with minimal cardiovascular risk factors. Cystic adventitial disease can affect both arteries and veins. Patients with arterial CAD present with sudden onset or rapidly progressing claudication symptoms, and those with venous CAD present with limb swelling or very rarely deep vein thrombosis. Diagnosis is confirmed with the aid of imaging techniques such as ultrasonography, computed tomography, or magnetic resonance scan. Surgical resection or evacuation of the lesion is usually the preferred approach, with only mixed results reported for percutaneous endovascular techniques.
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Affiliation(s)
- Sharath C. V. Paravastu
- Academic Vascular Unit, School of Health and Related Research, University of Sheffield, Sheffield, South Yorkshire, UK
| | - John M. Regi
- Department of Vascular Interventional Radiology, Northern General Hospital, Sheffield, South Yorkshire, UK
| | - Douglas R. Turner
- Department of Vascular Interventional Radiology, Northern General Hospital, Sheffield, South Yorkshire, UK
| | - Peter A. Gaines
- Department of Vascular Interventional Radiology, Northern General Hospital, Sheffield, South Yorkshire, UK
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Drac P, Köcher M, Utikal P, Cerna M, Kozak J, Bachleda P. CYSTIC ADVENTITIAL DISEASE OF THE POPLITEAL ARTERY: REPORT ON THREE CASES AND REVIEW OF THE LITERATURE. Biomed Pap Med Fac Univ Palacky Olomouc Czech Repub 2011; 155:309-21. [DOI: 10.5507/bp.2011.065] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
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23
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Use of 3.0-Tesla High Spatial Resolution Magnetic Resonance Imaging for Diagnosis and Treatment of Cystic Adventitial Disease of the Popliteal Artery. Ann Vasc Surg 2011; 25:385.e5-385.e10. [DOI: 10.1016/j.avsg.2010.09.010] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2010] [Revised: 09/04/2010] [Accepted: 09/08/2010] [Indexed: 11/19/2022]
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França M, Pinto J, Machado R, Fernandez GC. Case 157: Bilateral Adventitial Cystic Disease of the Popliteal Artery. Radiology 2010; 255:655-60. [DOI: 10.1148/radiol.10082211] [Citation(s) in RCA: 34] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
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25
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Maged IM, Turba UC, Housseini AM, Kern JA, Kron IL, Hagspiel KD. High spatial resolution magnetic resonance imaging of cystic adventitial disease of the popliteal artery. J Vasc Surg 2010; 51:471-4. [DOI: 10.1016/j.jvs.2009.08.079] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2009] [Revised: 08/25/2009] [Accepted: 08/25/2009] [Indexed: 10/19/2022]
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Sanchis García J, Palmero da Cruz J, Guijarro Rosaleny J, Gil Romero J. Enfermedad quística adventicial de la arteria poplítea: a propósito de un caso. RADIOLOGIA 2008; 50:532-3. [DOI: 10.1016/s0033-8338(08)76349-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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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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28
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Holden A, Merrilees S, Mitchell N, Hill A. Magnetic resonance imaging of popliteal artery pathologies. Eur J Radiol 2008; 67:159-68. [PMID: 17765423 DOI: 10.1016/j.ejrad.2007.06.015] [Citation(s) in RCA: 30] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2006] [Revised: 06/17/2007] [Accepted: 06/20/2007] [Indexed: 11/19/2022]
Abstract
This paper illustrates examples of popliteal artery pathologies imaged with contrast enhanced magnetic resonance angiography (CE-MRA) and magnetic resonance imaging (MRI) at a single tertiary referral centre. Popliteal artery pathologies were identified in 1710 patients referred over a 6-year period with symptoms suggesting lower limb arterial occlusive disease. Common pathologies such as atherosclerotic occlusive disease, thromboemboli and aneurysm disease are discussed as well as unusual pathologies such as cystic adventitial disease, mycotic aneurysm and arterial entrapment. The combination of CE-MRA and the excellent soft tissue resolution of MRI allow detailed evaluation of arterial and peri-arterial pathologies, and facilitate appropriate management decisions.
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Affiliation(s)
- Andrew Holden
- Department of Radiology, Auckland City Hospital, Park Road, Grafton, Auckland 9, New Zealand.
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29
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Abstract
Peripheral arterial disease is a main cause of morbidity in industrialised countries. It chiefly affects older people. The most common causes are atherosclerosis and vasodilatatory abnormalities. In the presence of unexplained leg symptoms, peripheral arterial disease can be diagnosed or ruled out by non-invasive diagnostic methods such as history, clinical examination and the measurement of ankle and brachial artery pressure by Doppler ultrasound, as well as by calculating the ankle brachial index. Colour coded duplex sonography, computer tomography angiography, magnetic resonance angiography and arteriography are the imaging modalities used. Current diagnostic strategies are analysed for the different peripheral artery diseases.
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Affiliation(s)
- R Vosshenrich
- Radiologen-Gemeinschaftspraxis, MRT im Friederikenstift, Hannover.
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30
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Imaging popliteal artery disease in young adults with claudication: self-assessment module. AJR Am J Roentgenol 2007; 189:S13-16. [PMID: 19642256 DOI: 10.2214/ajr.07.7020] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
The educational objectives of this self-assessment module on imaging popliteal artery disease in young adults with intermittent claudication are for the participant to exercise, self-assess, and improve his or her knowledge of the imaging and clinical features of popliteal artery entrapment syndrome, cystic adventitial disease,and masses associated with popliteal artery obstruction.
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31
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Affiliation(s)
- Huan Wang
- Department of Neurologic Surgery, Mayo Clinic, Rochester, MN 55905, USA
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32
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Abstract
Magnetic resonance angiography (MRA) has evolved over the past years from an experimental imaging modality to a technique that is now widely applied in clinical practice. This article reviews the fundamentals of the different magnetic resonance angiographic techniques and how they can be applied for abdominal and peripheral arterial imaging. Currently, contrast-enhanced magnetic resonance angiography (CE-MRA), whereby a luminogram is obtained during initial arterial passage of contrast material, is the most widely used technique. With current hardware and software, high-spatial resolution images of the abdominal aorta and proximal visceral branches can be obtained that are equivalent to intra-arterial digital subtraction angiography (IA-DSA). High-quality imaging of the renal arteries demands isotropic voxels and reformations orthogonal to the vessel axis for evaluation. Contrast-enhanced magnetic resonance angiography of the peripheral vascular tree is now a highly accurate technique and has replaced diagnostic intra-arterial digital subtraction angiography and duplex ultrasonography in many hospitals.
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Affiliation(s)
- Tim Leiner
- Maastricht University Hospital, Department of Radiology, Maastricht, The Netherlands.
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33
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Ortiz M WR, Lopera JE, Giménez CR, Restrepo S, Moncada R, Castañeda-Zúñiga WR. Bilateral Adventitial Cystic Disease of the Popliteal Artery: A Case Report. Cardiovasc Intervent Radiol 2005; 29:306-10. [PMID: 16228854 DOI: 10.1007/s00270-004-0300-5] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
Adventitial cystic disease (ACD) of the popliteal artery is an uncommon vascular condition of unknown etiology. In the present case report, we describe a case of bilateral ACD of the popliteal artery in a 58-year-old male. To the best of our knowledge, this is the first case of bilateral ACD of the popliteal artery reported in the literature.
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Affiliation(s)
- William R Ortiz M
- Department of Radiology, Louisiana State University Health Science Center, New Orleans, Louisiana, USA
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34
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Sapoval M, Long A, Saadi L, Krause D, Baqué J. Imagerie des pathologies vasculaires spécifiques. ACTA ACUST UNITED AC 2004; 85:913-26. [PMID: 15243368 DOI: 10.1016/s0221-0363(04)97699-8] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
The diagnosis of vascularitis should be proposed when a concentric and regular thickening of the wall of the aorta or one of its branches is observed or when there is late enhancement of the arterial wall, on sites which are usually free from atheromatous lesions and in a young patient. The radiologist must be aware of the associated clinical signs: oral and genital ulcerative lesions in the Behçet syndrome; finger necrosis in a young male smoker in Buerger disease; hip and shoulder arthropathy and headache in a 70 Year old female and Horton disease; pulseless upper limbs and inflammatory syndrome in a young adult for the Takayasu arteritis. The diagnosis of popliteal entrapment or adventitial cyst should be proposed in young patients without atheromatous lesions.
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Affiliation(s)
- M Sapoval
- Service de Radiologie Cardio-Vasculaire, Hôpital Européen Georges Pompidou, 20, rue Leblanc, 75015 Paris.
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