Cystic adventitial disease (CAD) is a rare vascular pathology which predominantly affects peripheral vessels of young otherwise healthy males. Much debate exists regarding its exact etiology. It is characterized by a collection of mucinous material within the adventitial wall layer of the affected vessel, resulting in arterial stenosis and rapidly progressive calf claudication. Treatment is primarily surgical, although radiological interventions have been reported. Its rarity makes evidence-based surgical or radiological management difficult. With this in mind, we report two cases of popliteal artery CAD treated successfully with primary excision and bypass grafting. We analyzed all literature published on CAD since first reported in 1947 and we propose an algorithm for appropriate management pathways.
AtkinsHJBKeyJA. A case of mixomatous tumour arising in the adventitia of the left external iliac artery. Br J Surg. 1947;34(136):426–427.
2.
EjrupBHiertonnT. Intermittent claudication; three cases treated by free vein graft. Acta Chir Scand. 1954;108(2-3):217–230.
3.
DesyNMSpinnerRJ. The etiology and management of cystic adventitial disease. J Vasc Surg. 2014;60(1):235–245.
4.
DracPKöcherMUtikalPCernaMKozakJBachledaP.Cystic adventitial disease of the popliteal artery: report on three cases and review of the literature. Biomed Pap. 2011;155(4):309–321.
IshikawaKMishimaYKobayashiS. Cystic adventitial disease of the popliteal artery. Angiology. 1961;12:357–366.
7.
FlaniganDBurnhamSJGoodreauJJBerganJJ. Summary of cases of adventitial cystic disease of the popliteal artery. Ann Surg. 1979;189(2):165–175.
8.
TomasianALaiCFinnJPGelabertHKrishnamMS. Cystic adventitial disease of the popliteal artery: features on 3 T cardiovascular magnetic resonance. J Cardiovasc Magn Reson. 2008;10:38.
LinquetteMMesmacqueRBeghinBHubschmanBSootsG. Degenere scence kystique de l’adventite de l ‘artere poplitee [in French]. Sem Hop. 1967;43(48):3005–3013.
11.
ShuteKRothnieNG. The aetiology of cystic arterial disease. Br J Surg. 1973;60(5):397–400.
12.
CassarKEngesetJ. Cystic adventitial disease: a trap for the unwary. Eur J Vasc Endovasc Surg. 2005;29(1):93–96.
13.
SaeedMWolfYGDilleyRB. Adventitial cystic disease of the popliteal artery mistaken for an endoluminal lesion. J Vasc Interv Radiol. 1993;4(6):815–818.
14.
ColombierDEliasARousseauHOtalPLegerPJoffreF. Cystic adventitial disease: importance of computed tomography in the diagnostic and therapeutic management. J Mal Vasc. 1997;22(3):181–186.
15.
DeutschALHydeJMillerSMDiamondCGSchancheAF. Cystic adventitial degeneration of the popliteal artery: CT demonstration and directed percutaneous therapy. AJR Am J Roentgenol. 1985;145(1):117–118. doi: 10.2214/ajr.145.1.117.
16.
EnglandPCkingJBetonDCHancockBD. Cystic adventitial disease of the popliteal artery. J R Soc Med. 1979;72(4):283–284.
17.
MagedIMTurbaUCHousseiniAMKernJAKronILHagspielKD. High spatial resolution magnetic resonance imaging of cystic adventitial disease of the popliteal artery. J Vasc Surg. 2010;51(2):471–474.
18.
FrançaMPintoJMachadoRFernandezGC. Case 157: bilateral adventitial cystic disease of the popliteal artery. Radiology. 2010;255(2):655–660. doi:10.1148/radiol.10082211.
19.
RispoliPMoniaciDZanSCassatella. Cystic adventitial disease of the popliteal artery. Report of 1 case and review of the literature. J Cardiovasc Surg (Torini). 2003;44(2):255–258.
20.
SeoHFujiiHAoyamaT. A case of adventitial cystic disease of the popliteal artery progressing rapidly after percutaneous ultrasound-guided aspiration. Ann Vasc Dis. 2014;7(4):417–420.
21.
ZhangHZhangYWangQZhaoWGWangJJ. Cystic adventitial disease of the popliteal artery: report of two cases. Surg Today. 2014;44(9):1760–1763.
22.
DeridderPVan der TempelGVanoverbekeHDecosterJVerheulG. Cystic adventitial disease of the popliteal artery: a case report. EJVES Extra. 2004;8(6):123–126.
23.
MenthaC. Degenerescence kystique adventitelle on bursite de l’artere poplitee. J Chir (Paris).1965;89:173–80.
24.
KhouryM. Failed angioplasty of a popliteal artery stenosis secondary to cystic adventitial disease: a case report. Vasc Endovasc Surg. 2004;38(3):277–280.
25.
RajSDaviesRVohraR. Failure of endovascular stenting for popliteal cystic disease. Ann Vasc Surg. 2009;23(3):410.e1–e5.
26.
MertensRMichel BergoeingMMarinéLValdésFKrämerA. Endovascular treatment of cystic adventitial disease of the popliteal artery. Ann Vasc Surg. 2013;27(8):1185.e1–e3.
27.
SetacciFSirignanoPde DonatoGChisciEPalascianoGSetacciC. Adventitial cystic disease of the popliteal artery: experience of a single vascular and endovascular center. J Cardiovasc Surg (Torino). 2008;49(2):235–239.
28.
PatelSMPatilVAPamoukianVN. Interposition grafting of popliteal artery cystic adventitial disease: case report. Vasc Endovascular Surg. 2008;42(2):192–195.
29.
OhtaTKatoRSugimotoIKondoMTsuchiokaH. Recurrence of cystic adventitial disease in an interposed graft. Surgery. 1994;116(3):587–592.
30.
TsolakisIAWalvatneCSCaldwellMD. Cystic adventitial disease of the popliteal artery: diagnosis and treatment. Eur J Vasc Endovasc Surg. 1998;15(3):188–194.
31.
BaxterARGargKLamparelloPJMussaFFCayneNSBerlandT. Cystic adventitial disease of the popliteal artery: is there a consensus in management?. Vascular. 2011;19(3):163–166.
32.
FoxRLKahnMAdlerJ. Adventitial cystic disease of the popliteal artery: failure of percutaneous transluminal angioplasty as a therapeutic modality. J vasc surg. 1985;2(3):464–467.
33.
OrtizM WRLoperaJEGiménezCRRestrepoSMoncadaRCastañeda-ZúñigaWR. Bilateral adventitial cystic disease of the popliteal artery: a case report. Cardiovas Intervent Radiol. 2006;29(2):306–310.
34.
BlissPB. Cystic myxomatous degeneration of the popliteal artery. Am Heart J. 1964;68:838–839.
