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[Cystic adventitial disease of the popliteal artery]
1Service de Chirurgie Cardio-Vasculaire A, Hôpital cardiologique, Lille.
Insights
Adventitial cystic disease is a rare vascular condition causing intermittent claudication in young patients. This condition involves a gelatinous lesion in the popliteal artery adventitia, distinct from atherosclerosis.
Area of Science:
- Vascular Surgery
- Vascular Pathology
Context:
- Adventitial cystic disease (ACD) is a rare, non-atherosclerotic condition.
- Historically described under various names like colloid degeneration or adventitial cyst.
- First documented in the iliac artery (1946), with early reports in the femoral and popliteal arteries.
Purpose:
- To differentiate adventitial cystic disease from other arterial pathologies.
- To highlight the typical presentation and surgical findings of ACD.
Summary:
- ACD presents as a cystic lesion within the adventitia of arteries, most commonly the popliteal artery.
- The lesion contains gelatinous material, which can be evacuated without entering the arterial lumen.
- Patients are typically young and present with severe intermittent claudication.
Impact:
- Clarifies the distinct nature of ACD compared to atherosclerosis and medial cystic necrosis.
- Aids in accurate diagnosis and surgical planning for this rare vascular condition.
Abstract:
This strange lesion has been described as colloid degeneration, adventitial cyst, adventitial cystic disease, cystic degeneration of the popliteal artery. The disease was also observed in other localizations and the first case, which was described in 1946 by Atkins and Key (I) concerned an iliac artery. Bizard (2) in 1978 reported a case of the common femoral artery. Ejrup and Hiertonn (4) described the first popliteal localization in 1954. Bergan in 1970 reported 40 cases and collected 115 operated cases in Rutherford's Vascular Surgery (5). Usually a young patient complaints from a recent severe intermittent claudication. At surgery a cystic lesion is found into the adventitia of the popliteal artery, containing gelatinous material which may be easily evacuated without opening the lumen of the artery. This lesion is totally different from atheroma and also from medial cystic necrosis as described by Erdheim.