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Cystic Adventitial Disease of the Popliteal Artery With Recurrent Intermittent Claudication After Drug-Coating Balloon Angioplasty: A Case Report Treated by Surgical Treatment

Cystic adventitial disease of the popliteal artery is a rare cause of unilateral intermittent claudication. The etiology of cystic adventitial disease is unknown, and affected patients are younger than those diagnosed with chronic arteriosclerosis. A 62-year-old man presented with a history of right...

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Autores principales: Tanaka, Shinichi, Tanaka, Kiyoshi, Okazaki, Jin
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Cureus 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9009971/
https://www.ncbi.nlm.nih.gov/pubmed/35444903
http://dx.doi.org/10.7759/cureus.23190
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author Tanaka, Shinichi
Tanaka, Kiyoshi
Okazaki, Jin
author_facet Tanaka, Shinichi
Tanaka, Kiyoshi
Okazaki, Jin
author_sort Tanaka, Shinichi
collection PubMed
description Cystic adventitial disease of the popliteal artery is a rare cause of unilateral intermittent claudication. The etiology of cystic adventitial disease is unknown, and affected patients are younger than those diagnosed with chronic arteriosclerosis. A 62-year-old man presented with a history of right leg claudication, which occurred after walking a distance of 500 m. The patient had no history of cardiovascular risk factors or trauma in the lower extremities. The ankle-brachial pressure index (ABI) was 0.58 in the affected leg. The patient was referred to the cardiovascular department. On Doppler ultrasonography, popliteal artery stenosis was detected. Following an angiogram, drug-coated balloon angioplasty was performed. The claudication improved, as indicated by an ABI of 1.11 in the affected leg. However, following one month of endovascular treatment, claudication had recurred, indicated by an ABI of 0.59. Computed tomography indicated the presence of a stenotic lesion in the popliteal artery, which may have developed from compression on the artery due to the presence of a surrounding periarterial cyst. The patient was subsequently diagnosed with cystic adventitial disease of the popliteal artery and was referred for vascular surgery. During surgery, the popliteal artery was exposed by the posterior approach; the artery showed circumferential enlargement and complete resection of the adventitial layer was performed. The patient had a successful postoperative recovery and the claudication disappeared (ABI of 1.14). Surgical management is an effective curative treatment for cystic adventitial disease of the popliteal artery that shows better efficacy than endovascular treatment. In the future, diagnostic methods for cystic adventitial disease should include computed tomography or magnetic resonance imaging with T1- and T2-weighted images.
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spelling pubmed-90099712022-04-19 Cystic Adventitial Disease of the Popliteal Artery With Recurrent Intermittent Claudication After Drug-Coating Balloon Angioplasty: A Case Report Treated by Surgical Treatment Tanaka, Shinichi Tanaka, Kiyoshi Okazaki, Jin Cureus Cardiac/Thoracic/Vascular Surgery Cystic adventitial disease of the popliteal artery is a rare cause of unilateral intermittent claudication. The etiology of cystic adventitial disease is unknown, and affected patients are younger than those diagnosed with chronic arteriosclerosis. A 62-year-old man presented with a history of right leg claudication, which occurred after walking a distance of 500 m. The patient had no history of cardiovascular risk factors or trauma in the lower extremities. The ankle-brachial pressure index (ABI) was 0.58 in the affected leg. The patient was referred to the cardiovascular department. On Doppler ultrasonography, popliteal artery stenosis was detected. Following an angiogram, drug-coated balloon angioplasty was performed. The claudication improved, as indicated by an ABI of 1.11 in the affected leg. However, following one month of endovascular treatment, claudication had recurred, indicated by an ABI of 0.59. Computed tomography indicated the presence of a stenotic lesion in the popliteal artery, which may have developed from compression on the artery due to the presence of a surrounding periarterial cyst. The patient was subsequently diagnosed with cystic adventitial disease of the popliteal artery and was referred for vascular surgery. During surgery, the popliteal artery was exposed by the posterior approach; the artery showed circumferential enlargement and complete resection of the adventitial layer was performed. The patient had a successful postoperative recovery and the claudication disappeared (ABI of 1.14). Surgical management is an effective curative treatment for cystic adventitial disease of the popliteal artery that shows better efficacy than endovascular treatment. In the future, diagnostic methods for cystic adventitial disease should include computed tomography or magnetic resonance imaging with T1- and T2-weighted images. Cureus 2022-03-15 /pmc/articles/PMC9009971/ /pubmed/35444903 http://dx.doi.org/10.7759/cureus.23190 Text en Copyright © 2022, Tanaka et al. https://creativecommons.org/licenses/by/3.0/This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
spellingShingle Cardiac/Thoracic/Vascular Surgery
Tanaka, Shinichi
Tanaka, Kiyoshi
Okazaki, Jin
Cystic Adventitial Disease of the Popliteal Artery With Recurrent Intermittent Claudication After Drug-Coating Balloon Angioplasty: A Case Report Treated by Surgical Treatment
title Cystic Adventitial Disease of the Popliteal Artery With Recurrent Intermittent Claudication After Drug-Coating Balloon Angioplasty: A Case Report Treated by Surgical Treatment
title_full Cystic Adventitial Disease of the Popliteal Artery With Recurrent Intermittent Claudication After Drug-Coating Balloon Angioplasty: A Case Report Treated by Surgical Treatment
title_fullStr Cystic Adventitial Disease of the Popliteal Artery With Recurrent Intermittent Claudication After Drug-Coating Balloon Angioplasty: A Case Report Treated by Surgical Treatment
title_full_unstemmed Cystic Adventitial Disease of the Popliteal Artery With Recurrent Intermittent Claudication After Drug-Coating Balloon Angioplasty: A Case Report Treated by Surgical Treatment
title_short Cystic Adventitial Disease of the Popliteal Artery With Recurrent Intermittent Claudication After Drug-Coating Balloon Angioplasty: A Case Report Treated by Surgical Treatment
title_sort cystic adventitial disease of the popliteal artery with recurrent intermittent claudication after drug-coating balloon angioplasty: a case report treated by surgical treatment
topic Cardiac/Thoracic/Vascular Surgery
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9009971/
https://www.ncbi.nlm.nih.gov/pubmed/35444903
http://dx.doi.org/10.7759/cureus.23190
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