Vasc Spec Int.  2019 Dec;35(4):217-224. 10.5758/vsi.2019.35.4.217.

Surgical Strategy to Reduce the Recurrence of Adventitial Cystic Disease after Treatment

Affiliations
  • 1Division of Vascular Surgery, Department of Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea. yangjin.park@samsung.com
  • 2Department of Surgery, Chonbuk National University Hospital, Jeonju, Korea.
  • 3Department of Surgery, Kangbuk Samsung Hospital, Seoul, Korea.

Abstract

PURPOSE
Adventitial cystic disease (ACD) is a rare condition that causes intermittent claudication and non-atherosclerotic disease without cardiovascular risk factors. The etiology and optimal treatment of ACD remain controversial. The purpose of this study was to analyze surgical treatment results for ACD and to elucidate optimal treatment options.
MATERIALS AND METHODS
We retrospectively reviewed 30 patients with ACD who underwent surgery from 2006 to 2018. Twenty-two patients had arterial ACD, six had venous ACD, and two had combined venous and arterial ACD. We reviewed demographic and clinical characteristics, treatment details, and procedure outcomes.
RESULTS
Recurrence occurred in 6 cases either after cyst excision alone (4/17) or patch angioplasty (2/2). There was no recurrence after vessel excision with interposition grafting (0/7). Therefore, vessel excision was a statistically significant factor in recurrence prevention (P=0.026). Among the six recurrences, joint connections of the cystic lesions were found in four of the six (66.7%).
CONCLUSION
As a curative surgery for ACD, vessel excision with interposition grafting is a better strategy to prevent recurrence than simple cyst excision alone.

Keyword

Adventitia; Cysts; Excision; Joint
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