Cystic Adventitial Disease Of The Popliteal Artery With Spontaneous Regression
Jibiki, M., Miyata, T., & Shigematsu, H. (2018). Cystic adventitial disease of the popliteal artery with spontaneous regression. Journal of vascular surgery cases and innovative techniques, 4(2), 136–139. https://doi.org/10.1016/j.jvscit.2018.01.006
View Original Source →Abstract
Cystic adventitial disease (CAD) of the popliteal artery with spontaneous regression is rare. We describe a 44-year-old man with rapid onset of severe intermittent claudication who is currently undergoing conservative follow-up. CAD was diagnosed, and resection of the lesion with autologous vein replacement was scheduled. However, the claudication suddenly improved at 5 weeks after onset. Computed tomography and ultrasound revealed that the cystic lesion in the adventitia had nearly disappeared. This case report describes the imaging findings and the possibility of conservative treatment. CAD can occur in the popliteal artery and is usually treated surgically. However, reports of spontaneous regression are rare. We report our experience with a case of CAD that eventually spontaneously regressed.
Case Details
Disease Location
Knee
Personal Characteristics
44-year-old man
Clinical Characteristics
Rapid onset of severe claudication after walking approximately 50 minutes. His ankle-brachial index (abi) was 0.9 on the right and 1.2 on the left. Contrast-enhanced computed tomography (CT) revealed a cystic lesion in the right popliteal artery wall occupying the intravascular lumen as well as multilocular cysts between the popliteal artery and femur. He was diagnosed with cystic adventitial disease (cad)
Remission Characteristics
The claudication suddenly improved 5 weeks after initial presentation. Therefore, contrast-enhanced CT was repeated and revealed that the cad had nearly disappeared.
Treatment & Mechanisms
Proposed Remission Mechanisms
The cad’s content may have passed through the periarterial space and through a communication with the articulation of the knee, and the cad and multilocular cysts collapsed because of a rise in internal pressure.
Non-Clinical Treatment
None reported