Cor Vasa 2022, 64(5):560-563 | DOI: 10.33678/cor.2021.098

Popliteal Adventitial Cystic Disease. Case Report

Vasil Chervenkov, Nikolay Dimitrov Valchev, Galina Kirova, Alexander Daskalov

Vascular Surgery Department, Acibadem Citi Clinic, Tokuda Hospital, Sofia, Bulgaria

Aim: We want to present a case of a patient who was diagnosed with the rare condition of popliteal adventitial cystic disease and to describe the diagnostic algorithm and the decision making process.

Methods: We report a case of a 51-year-old female nurse complaining of rapidly progressing claudication involving the right calf during exercise. She was misdiagnosed at the beginning and endovascular procedure was scheduled. Only by performing CT-scan and MRI the right diagnosis was made and open surgery was performed. The adventitial cyst was excised and the adventitia was left open. No further reconstruction was needed due to healthy and presumably strong arterial wall.

Results: The patient was discharged 2 days after the intervention with palpable distal pulse and no signs of right lower limb ischemia. Postoperative course was uneventful. The cyst was histologically similar to a ganglion.

Conclusion: We believe that in challenging diagnostic cases like this multidisciplinary approach is important to correctly identify the source of ischemia in a relatively healthy patient with no signs of multilevel atherosclerosis. Avoiding arterial reconstructions especially in a patient without appropriate venous conduit must be always considered a first line treatment.

Keywords: Claudication, Open surgery, Popliteal adventitial cystic disease

Received: July 21, 2021; Revised: July 21, 2021; Accepted: August 10, 2021; Published: November 1, 2022  Show citation