Summary of Cases of Adventitial Cystic Disease of the Popliteal Artery

Abstract

Adventitial cystic disease of the popliteal artery is explored. The results of correspondence with authors reporting this condition are elaborated upon. This has provided an opportunity to discuss the history of the condition, the findings in 115 cases which have come to the attention of the Correspondence Office dealing with this entity, and the results of treatment. A discussion of the suspected etiology of the condition is presented. The condition remains one of unknown etiology which can be treated by cyst evacuation or aspiration when the popliteal artery is patent and which is best treated by arterial reconstruction when the artery is occluded. The results of such treatment are good but are dependent upon technical excellence of the operative procedure.

Degeneración quística de la arteria poplítea: Presentación de caso clínico

“…Ocurre en varones de mediana edad, siendo generalmente unilateral y no necesariamente se encuentra en la adventicia 4,5,6,16 .…”

“…Ocurre principalmente en varones de mediana edad y generalmente afecta a la adventicia, pero puede comprometer otra capa de la pared arterial como en este caso, lo que es aún menos frecuente 4,5,6 .…”

Isquemia crítica em membro inferior em paciente jovem com doença cística de artéria poplítea

“…More comprehensive names, such as cystic disease, or degeneration of the arterial wall, or even degeneration or cystic disease of the popliteal artery, are more appropriate 11,12 . The pathogenesis of the disease remains unknown, but four theories have tried to explain it: microtrauma 13 ; systemic disease 4 ; embryonic origin 14 ; true synovial cysts 1,12,15,16 . The incidence of cystic disease of the popliteal artery is 1 case per 1,200 cases of intermittent claudication, or 1 case in 1,000 femoral angiographies performed 14 .…”

“…The pathogenesis of the disease remains unknown, but four theories have tried to explain it: microtrauma 13 ; systemic disease 4 ; embryonic origin 14 ; true synovial cysts 1,12,15,16 . The incidence of cystic disease of the popliteal artery is 1 case per 1,200 cases of intermittent claudication, or 1 case in 1,000 femoral angiographies performed 14 . This disease affects men more frequently, at a ratio men:women of 4:1 17 , and is more commonly observed in individuals in the fourth to the sixth decades of life.…”

Adventitial cystic disease of the popliteal artery: Failure of percutaneous transluminal angioplasty as a therapeutic modality

“…This is based on the high concentration of hyaluronic acid radicals in the mucopolysaccharide of the cyst, which is quite similar to that found in ganglia. ~4 Additional 'support for the ganglion theory is based on a number of reports linking the arterial cyst to the adjacent joint capsule, 6'1s-17 including the identification of synovialtype cells in the cyst wall and the demonstration of ACD in one case by arthr0graphy) 6 The relationship between ACD and true ganglia has important ramifications for therapy, particularly PTA. The mode of action by PTA in atherosclerosis is by cracking the brittle intima, thereby freeing and allowing stretching of the media.aS In the presence of ACD, vessels with "cystic" disease are much more compliant than atherosclerotic vessels and will therefore be more likely to resume their original stenotic configuration following dilatation.…”