Cystic adventitial disease of the popliteal artery: a recurrent case after cyst wall excision

Although atherosclerosis remains the most common cause of lower limb ischemia, cystic adventitial disease (CAD) must be considered in the differential diagnosis of a patient without risk factors for atherosclerosis. The disease typically produces lower limb claudication and usually affects young and middle-aged men. The treatment consists of interposition grafting in cases with an occluded artery, but the treatment of stenotic lesions without arterial occlusion is controversial whether evacuation with cyst wall excision or interposition grafting. We report a case of CAD of the popliteal artery in a 70-year-old man with recurrence two years after cyst wall excision. This case suggests that complete cyst wall excision and regular follow-up are crucial in the management of stenotic lesion with CAD. [Int Angiol 2012;31:198-201]