A Case of Cystic Adventitial Disease of the Popliteal Artery with Significant Stenosis Induced by Exercise Stress

Abstract

A 51-year-old man complained of intermittent claudication and fatigue in the right lower leg while he was playing tennis. Physical exam revealed normal pulsation at the popliteal and dorsalis pedis artery and ABI (ankle-brachial pressure index) was normal at the first visit. Duplex doppler ultrasound exam showed semi-circumferential cystic lesion without arterial stenosis in the popliteal artery. A month later, postexercise ABI reduced to 0.27 and duplex doppler ultrasound demonstrated arterial stenosis at the cystic lesion in the popliteal artery. The patient was diagnosed with cystic adventitial disease of the popliteal artery and underwent cyst wall resection under general anesthesia. Postoperative course was uneventful, and the symptom improved. Over three-year follow-up period, there has been no recurrence of the symptom and the adventitial cyst. The diagnosis by postexercise ABI was appropriate, and the surgery was effective treatment.