Abstract
Cystic adventitial disease is rare and its etiology remains controversial. A 53-year-old man suddenly felt languidness and pain in his right calf while he was working. Since his symptoms worsened, he consulted a physician 4 days later. Ankle-brachial systolic pressure index (ABI) was lower than normal in the right leg. The physician consulted our center on the suspicion of artery occlusion. Since emergency was not indicated, we decided to perform delayed surgery in the chronic period. A computed tomography (CT) showed a 3-cm obstruction of the right popliteal artery. No atherosclerotic findings were seen in the artery, and 1 month later, the symptoms had almost disappeared except the calf pain after stepping up stairs. CT and magnetic resonance imaging (MRI) showed a cystic adventitial disease and operation was performed. Popliteal artery and adventitial cyst were resected and interposed with saphenous vein graft. After operation, symptoms totally disappeared, and ABI was normal. Pathological findings showed attachment between the inner and outer elastic band. Adventitial cystic disease might originate from microtrauma.
