Cystic adventitial disease of the popliteal artery presenting with features of entrapment syndrome

Abstract

Cystic adventitial disease is an uncommon cause of lower extremity claudication resulting from accumulation of mucinous fluid in an arterial subadventitial layer, typically of the popliteal artery. A popliteal bruit and/or reduced distal pulses with knee flexion may be seen on examination. Alternatively, popliteal artery entrapment syndrome triggers claudication via an aberrant arterial pathway or muscular hypertrophy. Decreased distal pressures with plantar or dorsiflexion is a key finding. This report details the case of a middle-aged male with cystic adventitial disease whose diagnosis was complicated by concurrent features of popliteal artery entrapment syndrome. Treatment consisted of venous interposition grafting, which yielded excellent results.

Cystic adventitial disease of the popliteal artery: A case report with review of literature

“…Actually, MRI is the gold standard for diagnosis and surgical management of CAD [ 19 ]. Differential diagnosis considerations include popliteal artery entrapment syndrome (PAES) [ 2 , 6 , 20 ].…”

Long-Term Results of Surgical Treatment for Popliteal Artery Entrapment Syndrome

“…However, it is important to rule out other potential causes of ALI in pediatric patients, including premature accelerated atherosclerosis, microemboli, Takayasu’s arteritis, collagen vascular disease, coagulopathy, and the presence of a cystic adventitial disease (CAD). Notably, CAD is a rare condition, accounting for about 0.1% of vascular diseases [ 15 ]. It is characterized by the development of a cystic mass in the subadventitial layer of the vessel.…”

Successful surgical treatment of popliteal artery cystic adventitial disease

“…The disease most often affects the popliteal artery, less often described are changes in the external iliac artery, and femoral common artery as well as in the radial, ulna, brachial and axillary arteries [4]. There are isolated reports of vein involvement [5].…”