Abstract
Adventitial cystic disease of the popliteal artery is a rare condition that cause localized arterial stenosis or obstruction. We report a case of adventitial cystic disease of popliteal artery. A 55-years-old woman presenting left-sided intermitted claudication was diagnosed adventitial cystic disease and underwent endovascular therapy with balloon angioplasty in another hospital. She was referred to our hospital for reccurent symptom at one month after balloon angioplasty. The leftsided ankle brachial pressure index (ABI) was 0.59. From MRI findings and clinical course, we made diagnosis of restenosis of left popliteal artery caused by compression of adventitial cyst after balloon angioplasty, and then popliteal artery and adventitial cyst were resected and interposed with saphenous vein graft. Postoperatively the left-sided ABI improved to 1.04, and her symptom disappeared. The postoperative course was uneventful and she has been without reccurence for 24 months after surgery. In treatment for adventitial cystic disease, endovascular treatment by balloon angioplasty leads to early restenosis and early reccurence of symptom. Balloon angioplasty is not a durable treatment option for adventitial cystic disease. We think the best treatment is surgical treatment including cyst excision, resection of arterial segment and graft replacement.
