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Adventitial cystic disease (ACD) is a rare condition that typically presents in young healthy men with symptoms of claudication. ACD is characterized by formation of a mucinous cyst within the adventitia of a blood vessel, usually in the popliteal artery, causing compression of the vessel’s lumen and leading to reduced flow and symptoms of claudication. We have presented a rare case of ACD of the common femoral artery in a young female patient that was treated successfully with resection and femoral vein graft interposition reconstruction.

We report the case of a 61-year-old man who had presented with acute unilateral limb swelling. Computed tomography venography and duplex ultrasound demonstrated compression of the right common femoral vein by a common femoral vein adventitial cyst. Before intervention, the patient had developed an acute deep vein thrombosis of the right common femoral vein and great saphenous vein. Preoperative magnetic resonance imaging demonstrated concern for synovial connection. After 6 months of anticoagulation therapy, the patient underwent adventitial cyst excision with ligation of the hip joint articular connection. At 4 months postoperatively, the patient was symptom free without cyst recurrence. The findings from the present case support the synovial theory for adventitial cystic disease.

Adventitial Cystic Disease (ACD) is a rare cause of peripheral arterial disease that accounts for less than 1% of all causes of claudication. It typically presents in younger individuals and surgical reconstruction is the mainstay of treatment. We report a case of a 60-year-old, active female with progressively worsening claudication, who presented with ultrasound and computed tomography angiography revealing ACD involving the common femoral artery. The patient underwent a complete resection of the affected artery, which was replaced with an interposition Dacron bypass graft. We also present a comprehensive review of literature on surgical management of ACD of the femoral artery.

Adventitial cystic disease (ACD) is an uncommon condition that generally occurs at the popliteal artery but, rarely, can occur in the external iliac artery. To date, only eight cases of ACD occurring in the external iliac artery have been reported. We have reported the case of a 29-year-old man who had presented with new-onset claudication. Despite an extensive imaging workup, ACD was not confirmed until the gross intraoperative examination. We have reported our process of diagnosis and treatment in addition to that reported in previous studies to enhance the historical fund of knowledge for this rare pathology.

Cystic adventitial disease is a condition where mucinous cyst(s) develop within the adventitia of blood vessels, especially arteries. The most affected vessel is the popliteal artery while the upper limb vasculature is seldom involved. To our knowledge, there are only 2 articles reporting this disease in the ulnar artery. We present a case of a 52-year-old female patient, a manual worker in a clothing factory, with a month history of increasing pain in her right wrist and gradual weakness that incapacitated her for work activities. She was finally treated surgically and an adventitial cyst of the ulnar artery compressing the ulnar nerve was diagnosed.

Adventitial cystic disease of the venous system is an extremely rare condition. Forty-five cases have been described in the literature during the last 70 years, but they may not be representative of the real incidence of this pathologic process. We report a case of an adventitial cyst compressing the right external iliac vein and presenting with edema of the ipsilateral leg. Ultrasound imaging and computed tomography angiography showed the typical features of cystic disease and venous stenosis. Cyst excision was performed with a double surgical access. No perioperative complications were reported. There was no recurrence at 4-year follow-up.

Adventitial cystic disease (ACD) is a very rare condition characterized by the accumulation of a cyst filled with gelatinous substance in the adventitia of a vessel adjacent to the joint area. The cyst usually compresses the vessel lumen, causing claudication or leg swelling. The disease usually affects the popliteal artery. However, several cases of venous ACDs particularly in the common femoral or external iliac vein have been reported. The definition, diagnosis, and optimal treatment of ACD remain controversial because of its rarity and the inconsistent use of terminology. The heterogeneity of the reported cases is more prominent in venous ACD. Herein, the accurate terminology of cysts correlated to the joint (synovial cyst, ganglion cyst, and adventitial cyst) and the pathogenesis, anatomy, and optimal therapy of venous ACD are discussed in detail to establish reporting standards for future studies.

Adventitial cystic disease (ACD) of the veins is a rare vascular disease. Most cases of venous ACD are located adjacent to the joint area, such as the common femoral, external iliac, and popliteal veins. To the best of our knowledge, 67 cases of venous ACD have been reported, and ACD of the superficial femoral vein (SFV) has never been reported. Herein, we report the case of a 57-year-old male who presented with swelling and discomfort in the left leg. Computed tomography venography revealed multiple cystic lesions in the left distal SFV. The patient underwent cyst excision, which relieved the compression in the vein, although mild stenosis prevailed in the SFV. After a week, thrombosis developed in the popliteal vein. The thrombosis resolved after three months of anticoagulant therapy, and the patient showed no recurrence of ACD during three years of follow-up.

Adventitial cystic disease (ACD) is a rare condition. It affects mostly the popliteal artery, with few cases reported affecting the radial artery. This condition is characterized by accumulation of mucinous content at the adventitious layer.

Objectives: Cystic adventitial disease is an extremely rare vascular disorder and is often misdiagnosed. In order to improve the knowledge and treatment of this disease, a case of venous cystic adventitial disease was reported.Methods: The whole processes about the diagnosis and treatment of one patient with venous cystic adventitial disease was retrospectively studied.Results: This case of venous cystic adventitial disease was diagnosed accurately by contrast-enhanced computed tomography and treated successfully by surgical resection. No complications were detected after one-year post-operative follow-up.Conclusions: Surgical resection is a safe and effective method for the treatment of venous CAD. [ABSTRACT FROM AUTHOR]

Upper extremity adventitial cystic disease is rare, but the characteristic findings of this lesion should be known to the hand surgeon and used to guide treatment. We present a case of a young adult male who developed a painless mass in his distal forearm. Diagnostic imaging workup revealed a cystic mass that extended within and encased the radial artery. Both MRI and direct intraoperative visualization confirmed the presence of a stalk connecting the intra-mural radial artery mass to the radiocarpal joint. The mass and stalk were excised en bloc with fenestration of the volar capsule to prevent recurrence. This case demonstrates a less common example of upper extremity adventitial cystic disease and supports the articular theory of origin of these lesions. When surgical excision is performed, an attempt should be made to identify and excise the articular stalk in an effort to minimize risk of recurrence. [ABSTRACT FROM AUTHOR]

Adventitial cystic disease is an uncommon condition that is characterized by the collection of mucinous material that accumulates in the adventitial layer of the artery. Predominantly, this entity affects the popliteal artery, whereas it is extremely rare in the radial artery. We report a 72-year-old female patient that underwent surgical treatment of an adventitial cyst of the right radial artery. The involved arterial segment was resected, and reconstruction by means of the interposition of a saphenous vein graft was performed. Although the etiology is still debated, the finding of a pedicle through the superficial palmar branch of the radial artery connecting to the adjacent wrist joint reinforces the hypothesis of synovial origin. After 12 months, the patient is asymptomatic, and duplex ultrasound shows no signs of recurrence and patency of the bypass. This rare entity should be suspected when a pulsatile mass is noted in the radial artery because an early diagnosis and appropriate management may prevent further complications. [ABSTRACT FROM AUTHOR]

Adventitial cystic disease (ACD) is a vascular disorder most commonly affecting the popliteal artery. ACD is an uncommon and often misdiagnosed cause of lower extremity intermittent claudication that is usually acute in onset and of longer duration than claudication associated with atherosclerosis. We present two cases of ACD affecting the popliteal artery. [ABSTRACT FROM AUTHOR]

We report the case of a 68-year-old man with right intermittent claudication by adventitial cystic disease. We performed resection of the cyst and affected popliteal artery with interposing an autologous vein graft. Intraoperative findings revealed an intimal tear between the cyst and the compressed artery. His symptoms resolved after surgery, and the postoperative course was uneventful. Although adventitial cystic disease with intimal tear is rare, we consider that conventional surgical intervention remains the favorable treatment option for adventitial cystic disease. < Learning objective: We present a rare case of adventitial cystic disease (ACD) with intimal tear successfully treated with surgical repair. In the present case, intimal tear could not be detected preoperatively. Although this case is rare, we should pay attention to intimal tear in treating ACD. In case of ACD with intimal tear, resection of the affected artery and reconstruction with interposing graft are feasible.> [ABSTRACT FROM AUTHOR]

Adventitial cystic disease (ACD) is an unusual cystic tumor of blood vessels characterized by the accumulation of mucinous substance in the adventitia of the non-axial blood vessels adjacent to joints. Patients with ACD often suffer from intermittent claudication and/or limb pain, mostly involving the popliteal artery. We report a 30-year-old male who presented with intermittent claudication in his left leg. Angiography showed an obstructive lesion in the left popliteal artery. The lesion was treated successfully by surgical excision followed by graft vessel replacement. ACD involving the popliteal artery was diagnosed by pathologic findings of multiple cysts of the adventitia with external compression and focal narrowing of the vascular lumen. The cysts contained acid mucin and were partially lined by multiple rows of cytologically bland, synovium-like cells with positive immunoreactivity to vimentin and CD68 but negative immunoreactivity to cytokeratin. The histopathologic findings in this case suggest that it was caused by the developmental rests of mucin-secreting mesenchymal cells derived from the knee joint.

Adventitial Cystic Disease (ACD) is a vastly rare non-atherosclerotic vascular pathology that is principally manifested as intermittent claudication because of peripheral vascular ischemia. Precise etiological factors are not yet concretely identified, and it represents 0.1 % of all lower limb claudication causes. Middle-aged males are the most affected gender age group. Misdiagnosis of Popliteal Artery ACD could delay proper management and hence risk the loss of the affected limb due to critical limb ischemia. We hereby explore the rare case of a 51-year-old female patient, who complained of vague left lower extremity pain accompanied by paresthesia for 1 month prior to admission without signs of local inflammation. The preoperative radiological assessment suggested the presence of thrombosis within the left Popliteal Artery which caused an occlusion in it and hence the proper blood flow was compromised. Surgical intervention and the complete removal of the lesion along with establishing a patent synthetic anastomotic graft to maintain the preexisting vascular bundle was the key to treating our patient. Microscopic analysis of the excised specimen revealed an Adventitial Cystic Disease of the Popliteal Artery. Adventitial Cystic Disease represents an extremely rare vascular pathology with a vast margin of non-specific symptoms that could lead to misdiagnoses. It is fundamental to establish suitable preoperative screening protocols for it and sustain adequate levels of clinical awareness so that we can timely diagnose and in turn, achieve proper therapeutic interventions to plummet the potential disastrous complications that could ensue. • Adventitial Cystic Disease is a rare non-atherosclerotic vascular disease with ambiguous etiology. • Adventitial Cystic Disease comprises merely 0.1 % of the cases of lower limb intermittent claudication. • The prevalence of ACD among patients with vascular claudication is estimated to be 1 in 1200 cases. • ACD tends to occur more prominently in young to middle-aged males where the male-to-female ratio is 15:1. • Duplex ultrasound is key to diagnosing it and surgical excision limits the possibility of recurrence. [ABSTRACT FROM AUTHOR]

Venous adventitial cystic disease is a rare vascular disease. The objective of the study is to contemporarily review the literature of venous adventitial cystic disease and report three other new cases of adventitial cystic disease in common femoral vein. Articles published between 1947 and April 2013 were searched in OVID and PubMed databases. The search yielded only 38 reported cases of venous adventitial cystic disease. The general characteristics and disease management information of the 41 cases (including our current 3 cases) were analyzed. Venous adventitial cystic disease could develop late in life with an average age of 48.39 years (range, 5 to 77 years). Similar to arterial adventitial cystic disease, venous adventitial cystic disease was also found to have a male predominance (male to female ratio, 1.28:1). The common femoral vein was the most likely vein to be involved (65.9%, 27 cases). Right and left sides were almost equally affected. Extremity swelling (86.8%, 33 cases) was the main symptom of patients presenting with venous adventitial cystic disease. Excision of cyst wall in 30 patients (73.2%) was the main surgical procedure with a recurrence rate of 11.5%. Thirteen involved veins were resected; of which, 10 were reconstructed with prosthetic or autologous graft. No recurrence was reported in these 13 patients. Postoperatively, nine cases received an anticoagulation therapy. In conclusion, the etiology, treatment strategy, and outcomes of venous adventitial cystic disease could not be well understood in the present review due to limited numbers of cases. Studies with careful follow-up for at least up to first several months are recommended. [ABSTRACT FROM AUTHOR]

Adventitial cystic disease (ACD), also known as cystic mucoid or myxomatous degeneration, is a rare vascular disease seen mainly in arteries. It is very unusual for these cystic masses to develop in a vein. We report the case of a 56-year-old woman with leg swelling caused by ACD arising in the popliteal vein. The swelling appeared after a long period of standing. Magnetic resonance imaging (MRI) showed a popliteal cystic mass and venography showed disrupted venous flow. We resected the cyst wall without venous reconstruction, after which venous blood flow normalized and her symptoms subsided. To our knowledge, this is only the third documented case of ACD arising in the popliteal vein. A misdiagnosis could easily have been made, since the mass was not obvious on physical examination and the only symptom was intermittent swelling. Thus, it is important to be aware of ACD as a possible diagnosis when examining patients with a swelling in the leg. [ABSTRACT FROM AUTHOR]

Adventitial cystic disease of the femoral vein is an extremely rare condition; therefore, diagnosis, treatments, surgical approaches and long-term prognosis are not well defined. We report the case of a 67-year-old man with femoral vein adventitial cystic disease complicated with deep vein thrombosis. He presented with right leg oedema. Ultrasound, computed tomography and magnetic resonance imaging revealed a mass in the femoral vein, and deep vein thrombosis was not detected at the time. However, venous return disorder worsened due to the mass causing a deep vein thrombosis in the femoral vein, and anticoagulation therapy with edoxaban was administered. Subsequently, deep vein thrombosis in the femoral vein disappeared, but remained in the lower calf. The mass and femoral vein were completely resected and reconstructed with an expanded polytetrafluoroethylene graft. No recurrence was observed over 3 years and 3 months., (© The Author(s) 2021. Published by Oxford University Press on behalf of the European Association for Cardio-Thoracic Surgery. All rights reserved.)

Adventitial cystic disease (ACD) is a very rare condition characterized by the accumulation of a cyst filled with gelatinous substance in the adventitia of a vessel adjacent to the joint area. The cyst usually compresses the vessel lumen, causing claudication or leg swelling. The disease usually affects the popliteal artery. However, several cases of venous ACDs particularly in the common femoral or external iliac vein have been reported. The definition, diagnosis, and optimal treatment of ACD remain controversial because of its rarity and the inconsistent use of terminology. The heterogeneity of the reported cases is more prominent in venous ACD. Herein, the accurate terminology of cysts correlated to the joint (synovial cyst, ganglion cyst, and adventitial cyst) and the pathogenesis, anatomy, and optimal therapy of venous ACD are discussed in detail to establish reporting standards for future studies.

Adventitial cystic disease (ACD) is a rare condition in which a mucinous cyst forms within the adventitia, usually in arteries but rarely in veins. A 79-year-old patient presented with stomachache and nausea. Computerized tomography showed pelvic cysts on either side of the pelvis. The right tumor was 120×100 mm, and the left tumor was 45×35 mm. Our diagnosis was bilateral ovarian tumors and we performed laparoscopic tumor resection. In the abdominal cavity, we saw that the left ovary was swollen by about 3-4 cm and the right ovary was normal size. There was a mucous cyst located in the right retroperitoneal cavity that adhered around and bordered the right external iliac vein and the right obturator nerve. We peeled the adhesion away carefully and resected the tumor but the operation caused temporary obturator nerve paralysis. From pathological examination, we diagnosed the right retroperitoneal cyst to be venous ACD originating from the right external iliac vein. We found that venous ACD can grow as large as a pelvic tumor and is difficult to distinguish from an ovarian tumor, which is why we chose laparoscopic surgery. In this case, we performed the operation laparoscopically and no sequelae or recurrent tumor appeared during a 1-year follow-up. However, graft replacement is sometimes necessary for ACD, thus venous ACD should be considered a differential diagnosis and a surgical strategy should be developed when pelvic tumors are observed.