Abstract
Cystic adventitial disease (CAD) is a rare arterial disorder that can cause localized arterial stenosis or obstruction. This case report describes a 63-year-old woman presenting with right-sided intermittent claudication. Physical examination failed to identify any stigmata of generalized arterial disease. The right-sided ankle-brachial index at rest was 0.93. Color-coded Doppler sonography was diagnostic of a high-grade stenosis of the supragenicular popliteal artery, which was confirmed by computed tomography demonstrating the presence of a highly stenotic lesion in the right popliteal artery caused by protruding soft-tissue masses surrounding the artery. Magnetic resonance imaging revealed cystic lesions encompassing the right popliteal artery circumferentially. These cystic lesions exhibited low signal intensity on T1-weighted images and high signal intensity on T2-weighted images. Because of the characteristic location and clinical signs, CAD was suspected. Prior to surgery, we used Doppler sonography to determine our incision line. The popliteal artery was exposed via a posterior approach and showed circumferential enlargement. After complete resection of the adventitial layer, a yellowish-colored, pressurized, gelatinous, mucoid mass emerged. Arterial blood flow was fully restored by the end of the operation. The patient had an uneventful postoperative course and has remained free of symptoms for seven months.
