Cystic Adventitial Disease of the Popliteal Artery (Literature Review and Case Report)
Abstract
Cystic adventitial disease is a rare cause of unilateral intermittent claudication of unknown aetiology, which is characterized by the formation of multiple mucin-filled cysts in the adventitial layer of the arterial wall resulting in obstruction to blood flow. The disease predominantly presents in young otherwise healthy males and most commonly affects the popliteal artery (85 % of cases). Cystic adventitial degeneration can be diagnosed by duplex ultrasound, magnetic resonance imaging, magnetic resonance angiography, or computed tomographic angiography. Surgery is the primary mode of treatment, including replacement of the affected vascular segment by venous or synthetic interposition graft. Alternatively, the cysts can be drained by percutaneous ultrasound-guided needle aspiration. We conducted a literature review of the aetiology, diagnosis and treatment of this uncommon condition and present the case report.
About the Authors
T. V. Zakhmatova
Mechnikov North-West State Medical University, Ministry of Healthcare Russia
Russian Federation
Russian Federation
E. A. Egorova
Moscow State Medical University of Medicine and Dentistry named after A. I. Evdokoimov, Ministry of Healthcare of Russia
Russian Federation
Russian Federation
References
1. Allemang M. T., Kashyap V. S. Adventitial cystic disease of the popliteal artery // J. Vasc. Surg. 2015. V. 62. P. 490.
2. Atkins H. J., Key J. A. A case of myxomatous tumor arising in the adventitia of the left external iliac artery // Br. J. Surg. 1947. V. 34. P. 426-247.
3. Del Rey M. J., Fare R., Izquierdo E. et al. Clinicopathological correlations of podoplanin (gp38) expression in rheumatoid synovium and its potential contribution to fibroblast platelet crosstalk // PLoS One. 2014. V. 9. P. e99607.
4. Desy N. M., Spinner R. J. The etiology and management of cystic adventitial disease // J. Vasc. Surg. 2014. V. 60. P. 235-245.
5. Familiar A. G., Fernandez J. C. F., Abuın J. S. et al. Cystic adventitial disease of the popliteal artery // Cir. Esp. 2013. V. 91. № 9. P. 609-611.
6. Hao H., Ishibashi-Ueda H., Nishida N. et al. Distribution of myofibroblast and tenascin-C in cystic adventitial disease: comparison with ganglion // Pathol. Int. 2013. V. 63. P. 591-598.
7. Hernandez M. M., Serrano H. F. J., Lopez I. M. et al. Cystic adventitial degeneration of the popliteal artery: report on three cases and review of the literature // Ann. Vasc. Surg. 2014. V. 28. P. 1062-1069.
8. Keese M., Diehl S. J., Huck K. et al. Cystic adventitial degeneration of the popliteal artery // Ann. Vasc. Surg. 2012. V. 26. P. 859. e17-e21.
9. Kikuchi S., Sasajima T., Kokubo T. et al. Clinical results of cystic excision for popliteal artery cystic adventitial disease: long-term benefits of preserving the intact intima // Ann. Vasc. Surg. 2014. V. 28. P. 1567. e5-e8.
10. Ksepka M., Li A., Norman S. Cystic adventitial disease // Ultrasound Quarterly. 2015. V. 31. № 3. P. 224-226.
11. Maeda H., Umeda T., Kawachi H. et al. Cystic adventitial disease of the common femoral artery. Case report and review of the literature // Ann. Thorac. Cardiovasc. Surg. 2016. V. 22. № 5. P. 315-317.
12. Mateo M. M. H., Hernando F. J. S., Lopez I. M. et al. Cystic adventitial degeneration of the popliteal artery: report on 3 cases and review of the literature // Ann. Vasc. Surg. 2014. V. 28. P. 1062-1069.
13. Misselhorn D., Beresford T., Khanafer A. Early recurrence of cystic adventitial disease following cyst excision and bypass surgery // EJVES Extra. 2013. V. 26. № 6. P. 51-53.
14. Motaganahalli R. L., Smeds M. R., Harlander-Locke M. P., Lawrence P. F. A multi-institutional experience in adventitial cystic disease // J. of Vasc. Surg. 2017. V. 65. № 1. P. 157-161.
15. O’Valle F., Hernandez-Cortes P., Aneiros-Fernandez J. et al. Morphological and immunohistochemical evaluation of ganglion cysts. Cross-sectional study of 354 cases // Histol. Histopathol. 2014. V. 29. P. 601-607.
16. Paravastu S. C. V., Regi J. M., Turner D. R., Gaines P. A. A contemporary review of cystic adventitial disease // Vasc. Endovasc. Surg. 2012. V. 46. P. 5-14.
17. Park S. J., Park W. S., Min S. Yu. et al. Cystic adventitial disease of the common femoral artery at a previous surgical dissection site // Ann. Vasc. Surg. 2015. V. 29. P. 365.e1-e3.
18. Peruyera P., Del C., Va´zquez M. J. V.-V., Velasco M. B. et al. Cystic adventitial disease of the popliteal artery: two case reports and a review of the literature // Vasc. 2015. V. 23. № 2. P. 204-210.
19. Spinner R. J., Desy N. M., Agarwal G. et al. Evidence to support that adventitial cysts, analogous to intraneural ganglion cysts, are also joint-connected // Clin. Anat. 2013. V. 26. P. 267-281.
20. Talmon G., Wake L., Muirhead D. Podoplanin and clusterin are reliable markers of nonneoplastic synovium at various sites // Int. J. Surg. Pathol. 2013. V. 21. P. 587-590.
21. Taurino M., Rizzo L., Stella N. et al. Doppler ultrasonography and exercise testing in diagnosing a popliteal artery adventitial cyst // Cardiovasc. Ultrasound. 2009. V. 7. P. 23.
22. Warhadpande S., Go M. R., El Sayed H. et al. Popliteal artery cystic adventitial disease: early lessons in treatment // Ann. Vasc. Surg. 2017. V. 38. P. 255-259.
Review
For citations:
Zakhmatova T.V., Egorova E.A. Cystic Adventitial Disease of the Popliteal Artery (Literature Review and Case Report). Radiology - Practice. 2018;(6):35-45. (In Russ.)
Views:
332
Email this article 