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A Journal on Surgery

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Chirurgia 2007 October;20(5):245-7

language: English

Cystic adventitial disease of the popliteal artery. Rare case accompanied by a ganglion cyst

Ihaya A., Tanaka K., Kimura T., Morioka K., Uesaka T., Sasaki M., Tsuda T., Yamada N., Li W., Takamori A., Handa M., Tanaka S., Tanabe S.

Department of Surgery II Faculty of Medical Sciences University of Fukui, Fukui, Japan


Cystic adventitial disease (CAD) of the popliteal artery is an unusual cause of unilateral progressive intermittent claudication in young or middle-aged men. Regarding its exact etiology, there has been much speculation including the systemic disorder, traumatic, ganglion, and developmental theories. We present further evidence that CADs are rather adventitial ganglia, based on a lesion found in a 53-year-old man. Magnetic resonance imaging demonstrated not only a cystic mass compressing the popliteal arterial lumen but also another cystic lesion abutting the artery. Surgery was performed through a posterior approach using a modified Sims’ position. The second multilobulated cyst was a ganglion extending from the knee joint capsule but not compressing the artery. The contents of both cysts were similarly clear and gelatinous. Complete cyst excision of the affected segment of the popliteal artery was successfully performed. The patient has remained completely symptom free during the 3–year postoperative follow-up period. In our case, CAD may have represented a particular form of a ganglion.

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