Cystic adventitial disease

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[edit] Discussion of Cystic adventitial disease

  • Cystic adventitial disease (CAD) occurs when mucoid cysts in the adventitia compress the popliteal artery.
  • The popliteal artery is the most common location (85% of cases)
  • CAD is rare, accounting for only 0.1% of vascular disease.
  • Patients are usually men in their mid-40s who present with intermittent claudication.

  • Because CAD is a rare condition, treatment methods are derived anecdotally.
  • Surgical evacuation of the cysts with maintenance of the native artery appears to be the preferred treatment.
  • Occasionally, the artery cannot be preserved and a vein graft is required.

[edit] Imaging Findings for Cystic adventitial disease

[edit] US

  • Duplex US will depict an arterial stenosis with surrounding cysts, which contain no flow.
  • These cysts appear as anechoic or hypoechoic masses in the wall of the vessel.

[edit] MRI

  • The cysts can manifest as distinctive stenoses of the vessel lumen.
    • If the cysts are concentric, the stenosis will have an "hourglass" appearance
    • If they are eccentric, the stenosis will demonstrate the classic "scimitar sign."
  • Cysts are hyperintense on T2-weighted MR images and have variable signal intensity on T1-weighted images because of the variable amount of mucoid material within the cysts.
  • Compression of the popliteal artery produced by cysts can be seen on axial MR images and angiographically with three-dimensional time-of-flight imaging.

[edit] Images

Patient #1

[edit] See Also

[edit] External Links

[edit] References for Cystic adventitial disease