Vasc Spec Int.  2022 Jun;38(2):21. 10.5758/vsi.220020.

Inadvertent Stenting and Percutaneous Aspiration for Treatment of Adventitial Cystic Disease in the Popliteal Artery: A Case Report

Affiliations
  • 1Division of Vascular Surgery, Department of Surgery, Seoul National University College of Medicine, Seoul, Korea
  • 2Department of Radiology, Seoul National University College of Medicine, Seoul, Korea

Abstract

Adventitial cystic disease (ACD) is a rare, non-atherosclerotic disease that mainly affects the popliteal artery. Treatment is primarily surgical as endovascular approaches are affected by high recurrence rates. However, some studies have reported successful endovascular treatments of popliteal ACD cases. A 55-year-old female presented with right calf claudication. Computed tomography angiography revealed segmental occlusion of the right distal superficial femoral artery. Subsequently, a drug-eluting stent was successfully deployed. However, an unusual adventitial cystic lesion occluding the lumen that was characteristic of ACD was detected during a postoperative imaging review. It was aspirated using an ultrasound-guided percutaneous needle and drained using a pigtail catheter for 24 hours. Follow-up images after 39 months showed a patent artery with no recurrence of any cystic lesions, highlighting successful ACD treatment via stenting, ultrasound-guided aspiration, and cyst drainage. Stenting and cyst aspiration can be an alternative option for selected patients with ACD.

Keyword

Adventitia; Popliteal cyst; Stents; Puncture and aspiration
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