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Bae M, Huh U, Lee CW, Kim JW. Venous adventitial cystic disease is a very rare disease that can cause deep vein thrombosis: A case report. World J Clin Cases 2023; 11:8170-8175. [PMID: 38130778 PMCID: PMC10731187 DOI: 10.12998/wjcc.v11.i34.8170] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/28/2023] [Revised: 10/26/2023] [Accepted: 11/28/2023] [Indexed: 12/06/2023] Open
Abstract
BACKGROUND Venous adventitial cystic disease (VACD) is a rare disease characterized by cysts, filled with a gelatinous mucous substance similar to joint fluid, in the adventitia of blood vessels adjacent to the joints. It is often misdiagnosed as deep vein thrombosis (DVT), femoral varices, venous tumors, or lymphadenopathy. CASE SUMMARY A 69-year-old woman visited our hospital with a complaint of swelling in the right lower extremity. The patient was diagnosed with DVT and prescribed apixaban at an outpatient clinic. After 3 wk, the patient was hospitalized again because of sudden swelling in the right lower extremity. We diagnosed VACD and performed surgery for cyst removal as well as patch angioplasty and thrombectomy of the right common femoral vein. The patient received anticoagulants for 6 mo and has been doing well without recurrence for 1 year postoperatively. CONCLUSION Recurrent VACD requires complete removal of the connections to the joint cavity to prevent recurrence.
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Affiliation(s)
- Miju Bae
- Department of Thoracic and Cardiovascular Surgery, Pusan National University School of Medicine, Busan 49241, South Korea
- Biomedical Research Institute, Pusan National University Hospital, Busan 49241, South Korea
| | - Up Huh
- Department of Thoracic and Cardiovascular Surgery, Pusan National University School of Medicine, Busan 49241, South Korea
- Biomedical Research Institute, Pusan National University Hospital, Busan 49241, South Korea
| | - Chung Won Lee
- Department of Thoracic and Cardiovascular Surgery, Pusan National University School of Medicine, Busan 49241, South Korea
- Biomedical Research Institute, Pusan National University Hospital, Busan 49241, South Korea
| | - Jong Won Kim
- Department of Thoracic and Cardiovascular Surgery, Pusan National University School of Medicine, Busan 49241, South Korea
- Biomedical Research Institute, Pusan National University Hospital, Busan 49241, South Korea
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2
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Biggs JH, Kalra M, Skinner JA, DeMartino RR. Adventitial cystic disease of the common femoral vein: an unusual cause of lower extremity swelling and review of the literature. JOURNAL OF VASCULAR SURGERY CASES INNOVATIONS AND TECHNIQUES 2021; 7:610-616. [PMID: 34746527 PMCID: PMC8551497 DOI: 10.1016/j.jvscit.2021.06.015] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/06/2021] [Accepted: 06/25/2021] [Indexed: 11/24/2022]
Abstract
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.
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Affiliation(s)
- Joedd H Biggs
- Division of Vascular and Endovascular Surgery, Mayo Clinic, Rochester, Minn
| | - Manju Kalra
- Division of Vascular and Endovascular Surgery, Mayo Clinic, Rochester, Minn
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3
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Tan R, Tosenovsky P. Venous Adventitial Cyst Mimicking a Persistent Femoral Deep Venous Thrombosis. Ann Vasc Surg 2021; 73:511-514. [PMID: 33515660 DOI: 10.1016/j.avsg.2020.12.014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2020] [Revised: 11/13/2020] [Accepted: 12/01/2020] [Indexed: 11/29/2022]
Abstract
OBJECTIVE We describe the case of lower limb unilateral swelling due to a cystic mass (adventitial cystic disease) compressing on the common femoral vein. This was misdiagnosed as a deep vein thrombosis on both computed tomography venography and Doppler ultrasound. METHOD We describe the diagnostic pathways and surgical excision of this venous adventitial cyst of the femoral vein. CONCLUSION Venous adventitial cysts are a rare occurrence and diagnosis remains difficult. It often presents clinically as a Deep Vein Thrombosis (DVT). Suspicions should be raised should symptoms persist despite appropriate DVT management. Surgical management include endovascular, minimally invasive procedures, and complete evacuation of the mucoid cyst with excision of the cystic wall.
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Affiliation(s)
- Rebekah Tan
- Department of Vascular and Endovascular Surgery, Royal Perth Hospital, Perth, Australia.
| | - Patrik Tosenovsky
- Department of Vascular and Endovascular Surgery, Royal Perth Hospital, Perth, Australia
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4
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Min SH, Kim JH. Adventitial Cystic Disease of the Common Femoral Vein Mimicking Deep Venous Thrombosis: A Case Report. JOURNAL OF THE KOREAN SOCIETY OF RADIOLOGY 2021; 82:1315-1320. [PMID: 36238395 PMCID: PMC9432374 DOI: 10.3348/jksr.2020.0130] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/30/2020] [Revised: 09/23/2020] [Accepted: 01/11/2021] [Indexed: 11/15/2022]
Affiliation(s)
- Sun Ha Min
- Department of Radiology, Sanggye Paik Hospital, Inje University College of Medicine, Seoul, Korea
| | - Jae Hyung Kim
- Department of Radiology, Sanggye Paik Hospital, Inje University College of Medicine, Seoul, Korea
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Min SK, Han A, Min S, Park YJ. Inconsistent Use of Terminology and Different Treatment Outcomes of Venous Adventitial Cystic Disease: A Proposal for Reporting Standards. Vasc Specialist Int 2020; 36:57-65. [PMID: 32611837 PMCID: PMC7333088 DOI: 10.5758/vsi.200029] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2020] [Accepted: 05/21/2020] [Indexed: 01/21/2023] Open
Abstract
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.
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Affiliation(s)
- Seung-Kee Min
- Division of Vascular Surgery, Department of Surgery, Seoul National University College of Medicine, Seoul, Korea
| | - Ahram Han
- Division of Vascular Surgery, Department of Surgery, Seoul National University College of Medicine, Seoul, Korea
| | - Sangil Min
- Division of Vascular Surgery, Department of Surgery, Seoul National University College of Medicine, Seoul, Korea
| | - Yang-Jin Park
- Division of Vascular Surgery, Department of Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
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6
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Tinelli G, Montanari F, Minelli F, De Nigris F, Sica S, Tshomba Y. Long-term follow-up of adventitial cyst surgical excision in external iliac vein. JOURNAL OF VASCULAR SURGERY CASES INNOVATIONS AND TECHNIQUES 2020; 6:320-323. [PMID: 33367187 PMCID: PMC7748988 DOI: 10.1016/j.jvscit.2020.04.008] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/25/2020] [Accepted: 04/24/2020] [Indexed: 11/29/2022]
Abstract
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.
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Affiliation(s)
- Giovanni Tinelli
- Correspondence: Giovanni Tinelli, MD, PhD, Chirurgia Vascolare, Polo CardioVascolare e Toracico, Fondazione Policlinico Universitario Gemelli IRCCS-Università Cattolica del Sacro Cuore, Largo Agostino Gemelli, 8, 00168 Rome, Italy
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Abstract
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.
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Affiliation(s)
- Facai Guo
- Department of Vascular Surgery, Lanzhou University Second Hospital, Lanzhou, China
| | - Yi Guo
- Department of General Surgery, Chongqing University Central Hospital (Chongqing Emergency Medical Center), Chongqing, China
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8
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Sonobe A, Kato H, Mathis BJ, Tsukada T, Matsubara M, Sakamoto H, Hiramatsu Y. Surgical Resection of an Adventitial Cyst of the Right Brachiocephalic Vein. Ann Thorac Surg 2020; 110:e201-e203. [PMID: 32114047 DOI: 10.1016/j.athoracsur.2020.01.022] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/27/2019] [Revised: 01/08/2020] [Accepted: 01/08/2020] [Indexed: 11/29/2022]
Abstract
Adventitial cystic disease is an uncommon vascular anomaly known to occur in peripheral vessels but mediastinal appearances are extremely rare. Herein, we report the case of an adventitial cyst occurring in the right brachiocephalic vein which might have been associated with ovarian hyperstimulation syndrome.
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Affiliation(s)
- Aiko Sonobe
- Division of Cardiovascular Surgery, University of Tsukuba, Tsukuba, Ibaraki, Japan
| | - Hideyuki Kato
- Division of Cardiovascular Surgery, University of Tsukuba, Tsukuba, Ibaraki, Japan.
| | - Bryan J Mathis
- Division of Cardiovascular Surgery, University of Tsukuba, Tsukuba, Ibaraki, Japan
| | - Toru Tsukada
- Division of Cardiovascular Surgery, University of Tsukuba, Tsukuba, Ibaraki, Japan
| | - Muneaki Matsubara
- Division of Cardiovascular Surgery, University of Tsukuba, Tsukuba, Ibaraki, Japan
| | - Hiroaki Sakamoto
- Division of Cardiovascular Surgery, University of Tsukuba, Tsukuba, Ibaraki, Japan
| | - Yuji Hiramatsu
- Division of Cardiovascular Surgery, University of Tsukuba, Tsukuba, Ibaraki, Japan
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9
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Lun Y, Zhang J, Jiang H, Xu D, Sun J, Wang S, Xin S. Treatment Options for Venous Cystic Adventitial Disease: A Case Report and Literature Review. Ann Vasc Surg 2019; 64:413.e1-413.e4. [PMID: 31669477 DOI: 10.1016/j.avsg.2019.10.057] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2019] [Revised: 09/29/2019] [Accepted: 10/12/2019] [Indexed: 12/01/2022]
Abstract
Venous cystic adventitial disease (CAD) is an uncommon vascular anomaly that most frequently affects the common femoral vein. Transluminal or transadventitial evacuation followed by cyst excision is considered an effective treatment for this condition, although the recurrence rate is relatively high. Herein, we report a case of a 59-year-old man with venous CAD that was successfully treated with saphenous vein patch angioplasty after mucoid evacuation and cyst excision, and we discuss the options for treating venous CAD.
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Affiliation(s)
- Yu Lun
- Department of Vascular Surgery, The First Hospital, China Medical University, Shenyang, China
| | - Jian Zhang
- Department of Vascular Surgery, The First Hospital, China Medical University, Shenyang, China.
| | - Han Jiang
- Department of Vascular Surgery, The First Hospital, China Medical University, Shenyang, China
| | - Dongdong Xu
- Department of Vascular Surgery, The First Hospital, China Medical University, Shenyang, China
| | - Jianjian Sun
- Department of Vascular Surgery, The First Hospital, China Medical University, Shenyang, China
| | - Shiyue Wang
- Department of Vascular Surgery, The First Hospital, China Medical University, Shenyang, China
| | - Shijie Xin
- Department of Vascular Surgery, The First Hospital, China Medical University, Shenyang, China
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10
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Liu P, Yan B, Zhang Y, Yan J, Ma C, Wang G, Jian T, Sun Z. Cystic adventitial disease of femoral vein presenting as enlarging lower limb swelling and pain: Two case reports and review of the literature. Exp Ther Med 2019; 18:3563-3567. [PMID: 31602233 PMCID: PMC6777217 DOI: 10.3892/etm.2019.7992] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2019] [Accepted: 08/05/2019] [Indexed: 11/26/2022] Open
Abstract
Cystic adventitial disease (CAD) is a condition that mainly affects the arterial system but rarely involves the venous system. The present study reported on two cases of CAD of femoral veins. The clinical manifestations in the two patients included pain and swelling of the lower limbs, but they had no risk factors for venous thrombosis. Color ultrasonography indicated cystic space-occupying lesions around the femoral veins, and enhanced computed tomography (CT) revealed vascular compression and space-occupying properties of the femoral veins. The two patients underwent open surgery, the postoperative treatment was uneventful, and swelling and tenderness were completely resolved. The pathological examination confirmed CAD of femoral vein in the two patients. The enhanced CT venography scan indicated patency of the femoral vein in the two patients following the operation. The circumferences of the two patients' lower limbs had returned to normal at the 2-month follow-up. A review of the literature was performed, and the presentation, diagnosis, treatment and pathology of this rare condition were discussed.
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Affiliation(s)
- Peng Liu
- Department of Vascular Surgery, Affiliated Hospital of Jining Medical University, Jining, Shandong 272029, P.R. China
| | - Bin Yan
- Intensive Care Unit of Vascular Surgery, Xuanwu Hospital of Capital Medical University, Beijing 100053, P.R. China
| | - Yanhui Zhang
- Department of Oncology, Affiliated Hospital of Jining Medical University, Jining, Shandong 272029, P.R. China
| | - Jingwei Yan
- Department of Vascular Surgery, Affiliated Hospital of Jining Medical University, Jining, Shandong 272029, P.R. China
| | - Chong Ma
- Department of Vascular Surgery, Affiliated Hospital of Jining Medical University, Jining, Shandong 272029, P.R. China
| | - Guodong Wang
- Department of Vascular Surgery, Affiliated Hospital of Jining Medical University, Jining, Shandong 272029, P.R. China
| | - Tao Jian
- Department of Vascular Surgery, Affiliated Hospital of Jining Medical University, Jining, Shandong 272029, P.R. China
| | - Ziqiang Sun
- Department of Vascular Surgery, Affiliated Hospital of Jining Medical University, Jining, Shandong 272029, P.R. China
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11
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Abstract
Adventitial cystic disease (ACD) of the radial artery is a rare condition, with few cases described in the literature. We report the case of a 62-year-old white male with a history of diabetes, hypertension, and chronic kidney disease with indications for renal replacement therapy who was found to have a cystic lesion of the radial artery while undergoing surgical creation of an arteriovenous fistula. The surgical technique adopted was resection of the cystic segment and preservation of the radial artery. Fistula creation was completed successfully. Early diagnosis and appropriate treatment of ACD are effective, and can prevent complications and recurrence.
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12
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Priya S, Steigner M. Images in Vascular Medicine: Cystic adventitial disease involving external iliac vein: A rare cause of unilateral limb swelling. Vasc Med 2018; 23:86-87. [PMID: 29325500 DOI: 10.1177/1358863x17747513] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Affiliation(s)
- Sarv Priya
- Department of Noninvasive Cardiovascular Imaging, Brigham & Women's Hospital, Boston, USA
| | - Michael Steigner
- Department of Noninvasive Cardiovascular Imaging, Brigham & Women's Hospital, Boston, USA
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13
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Howard E, Benson R, Day C, Gwynn B. Cystic adventitial disease of the common femoral vein. BMJ Case Rep 2017; 2017:bcr-2017-219818. [PMID: 28490479 DOI: 10.1136/bcr-2017-219818] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
We present the case of a 46-year-old commercial pilot with a history of unilateral leg swelling following a flight to Geneva. Although initial clinical examination suggested a deep vein thrombosis, the swelling only partially resolved with anticoagulation and further imaging suggested the presence of adventitial cystic disease (ACD). The patient underwent initial anticoagulation to allow any thrombus to be lysed, followed by excision of the ACD from the venous wall and venous reconstruction. Following the excision of the ACD, providing the patient remains asymptomatic and further imaging finds normal venous anatomy, we hope the patient will discontinue anticoagulation and return to flying.
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Affiliation(s)
- Emma Howard
- School of Medicine, Keele University, Keele, UK
| | - Ruth Benson
- Department of Vascular Surgery, University Hospitals of North Midlands NHS Trust, Stoke-on-Trent, Staffordshire, UK
| | - Christopher Day
- Department of Radiology, University Hospitals of North Midlands NHS Trust, Stoke-on-Trent, Staffordshire, UK
| | - Brian Gwynn
- Department of Vascular Surgery, University Hospitals of North Midlands NHS Trust, Stoke-on-Trent, Staffordshire, UK
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14
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Venous Adventitial Cystic Disease: A Review of 45 Cases Treated Since 1963. Int J Vasc Med 2016; 2016:5287697. [PMID: 27885342 PMCID: PMC5112310 DOI: 10.1155/2016/5287697] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2016] [Accepted: 09/05/2016] [Indexed: 12/03/2022] Open
Abstract
Purpose. To review and identify the most accurate ways of diagnosing and treating adventitial cystic disease (ACD) of the venous system. Methods. Cases of ACD were collected through three popular medical databases, including PubMed, Cochrane, OVID, and MEDLINE. After reviewing the literature, the sites of occurrence of 323 cases of adventitial cystic disease were documented, and all cases of arterial ACD were excluded. The clinical features, treatment, and subsequent course of 45 cases of venous ACD are included in this paper. Results. After reviewing all 45 cases of venous ACD , we have confirmed that the most common vessel affected is the common femoral vein, which reproduces the most common symptom of venous ACD: asymmetric lower extremity swelling worsening over time. Conclusion. Venous ACD most commonly affects the common femoral vein. When unilateral leg swelling occurs with or without a noticeable mass, ACD should be considered. It is best confirmed with CT venography and the treatment of choice is transluminal cyst evacuation and excision.
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Marzo Álvarez A, Pobo Ruiz V, Carranza Martínez J, Soguero Valencia I, Rivera Rodríguez M. Enfermedad quística subadventicial en vena femoral común. ANGIOLOGIA 2016. [DOI: 10.1016/j.angio.2015.03.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
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16
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Vasconcelos RS, Cherubim CA, França FMP, D'allacqua EDL, Dalio MB, Joviliano EE. Doença cística da adventícia na veia basílica: relato de caso. J Vasc Bras 2016; 15:245-249. [PMID: 29930597 PMCID: PMC5829763 DOI: 10.1590/1677-5449.002616] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
A doença cística da adventícia é uma entidade rara que acomete principalmente a artéria poplítea. A ocorrência em veias é muito rara, e sua etiologia é desconhecida. Clinicamente, apresenta-se como isquemia, trombose ou dor a depender do território acometido. Apresentamos o caso de um paciente masculino jovem referindo nódulo no braço esquerdo. A angiorressonância magnética do membro mostrou lesão cística em contato com a veia basílica, com conteúdo homogêneo e sem realce pós-contraste. Foi realizada ressecção da lesão em bloco com o segmento venoso envolvido. O estudo anatomopatológico foi sugestivo de cisto de adventícia de veia basílica.
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Affiliation(s)
- Rafael Sampaio Vasconcelos
- Universidade de São Paulo - USP, Faculdade de Medicina de Ribeirão Preto, Hospital das Clínicas, Departamento de Cirurgia e Anatomia, Divisão de Cirurgia Vascular e Endovascular, Ribeirão Preto, SP, Brasil
| | - Cesar Augusto Cherubim
- Universidade de São Paulo - USP, Faculdade de Medicina de Ribeirão Preto, Hospital das Clínicas, Departamento de Cirurgia e Anatomia, Divisão de Cirurgia Vascular e Endovascular, Ribeirão Preto, SP, Brasil
| | - Felipe Mavignier Pereira França
- Universidade de São Paulo - USP, Faculdade de Medicina de Ribeirão Preto, Hospital das Clínicas, Departamento de Cirurgia e Anatomia, Divisão de Cirurgia Vascular e Endovascular, Ribeirão Preto, SP, Brasil
| | - Eduardo de Lucca D'allacqua
- Universidade de São Paulo - USP, Faculdade de Medicina de Ribeirão Preto, Hospital das Clínicas, Departamento de Cirurgia e Anatomia, Divisão de Cirurgia Vascular e Endovascular, Ribeirão Preto, SP, Brasil
| | - Marcelo Bellini Dalio
- Universidade de São Paulo - USP, Faculdade de Medicina de Ribeirão Preto, Hospital das Clínicas, Departamento de Cirurgia e Anatomia, Divisão de Cirurgia Vascular e Endovascular, Ribeirão Preto, SP, Brasil
| | - Edwaldo Edner Joviliano
- Universidade de São Paulo - USP, Faculdade de Medicina de Ribeirão Preto, Hospital das Clínicas, Departamento de Cirurgia e Anatomia, Divisão de Cirurgia Vascular e Endovascular, Ribeirão Preto, SP, Brasil
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17
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Kim YK, Chun HJ, Hwang JK, Kim JI, Kim SD, Park SC, Moon IS. Adventitial cystic disease of the common femoral vein presenting as deep vein thrombosis. Asian J Surg 2016; 39:178-81. [DOI: 10.1016/j.asjsur.2013.07.002] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2012] [Revised: 11/15/2012] [Accepted: 07/09/2013] [Indexed: 11/29/2022] Open
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Apigian AK, Landry GJ. Basic data underlying decision making in nonatherosclerotic causes of intermittent claudication. Ann Vasc Surg 2014; 29:138-53. [PMID: 25277047 DOI: 10.1016/j.avsg.2014.09.013] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2014] [Accepted: 09/17/2014] [Indexed: 01/13/2023]
Abstract
Although most cases of vasculogenic intermittent claudication are caused by atherosclerosis, there is an important minority of cases that are due to nonatherosclerotic causes. Because of their rarity and younger population affected, often without traditional atherosclerotic risk factors, there is frequently a significant delay in diagnosis of nonatherosclerotic peripheral arterial diseases by several months to years in some cases. Here, we review the literature on nonatherosclerotic causes of lower extremity claudication, symptoms, management including surgical and endovascular interventions, and outcomes. Conditions included are popliteal artery entrapment syndrome, cystic adventitial disease, pseudoxanthoma elasticum, persistent sciatic artery, fibromuscular disease, giant cell arteritis, iliac endofibrosis, neurogenic claudication, and chronic exertional compartment syndrome.
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Affiliation(s)
- Aimie K Apigian
- Knight Cardiovascular Institute, Oregon Health & Science University, Sam Jackson Park Road, Portland, OR
| | - Gregory J Landry
- Knight Cardiovascular Institute, Oregon Health & Science University, Sam Jackson Park Road, Portland, OR.
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19
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Del Canto Peruyera P, Vázquez MJVV, Velasco MB, Álvarez PC, Salgado AÁ, Álvarez JC, Fernández LJÁ. Cystic adventitial disease of the popliteal artery: Two case reports and a review of the literature. Vascular 2014; 23:204-10. [PMID: 24986869 DOI: 10.1177/1708538114541652] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Two cases of cystic adventitial disease treated at our institution over the last year are presented. They were middle-aged and apparently healthy patients, and the symptoms begin with a sudden onset of unilateral claudication. After performing a magnetic resonance angiography, a cystic formation attached to the adventitia of the popliteal artery was identified. Both patients were treated in the same manner, with resection of the affected arterial segment and vein bypass interposition. Both remain asymptomatic after one year of follow-up in one case and six months in the other. Cystic adventitial disease is a rare entity, which presents in patients without cardiovascular risk factors, so sometimes it takes long to reach a definitive diagnosis. Concerning the different treatment options, cyst excision together with the affected arterial segment seems to offer better mid- and long-term results when compared with other treatment options such as cyst aspiration or endovascular techniques, although there are no multicenter trials evidencing the superiority of one against the others.
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Affiliation(s)
- P Del Canto Peruyera
- Department of Angiology, Vascular and Endovascular Surgery, Cabueñes Hospital, Gijón, Spain
| | | | - M Botas Velasco
- Department of Angiology, Vascular and Endovascular Surgery, Cabueñes Hospital, Gijón, Spain
| | - P Calvín Álvarez
- Department of Angiology, Vascular and Endovascular Surgery, Cabueñes Hospital, Gijón, Spain
| | - A Álvarez Salgado
- Department of Angiology, Vascular and Endovascular Surgery, Cabueñes Hospital, Gijón, Spain
| | - J Cerviño Álvarez
- Department of Angiology, Vascular and Endovascular Surgery, Cabueñes Hospital, Gijón, Spain
| | - L J Álvarez Fernández
- Department of Angiology, Vascular and Endovascular Surgery, Cabueñes Hospital, Gijón, Spain
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20
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Desy NM, Spinner RJ. The etiology and management of cystic adventitial disease. J Vasc Surg 2014; 60:235-45, 245.e1-11. [DOI: 10.1016/j.jvs.2014.04.014] [Citation(s) in RCA: 78] [Impact Index Per Article: 7.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2014] [Accepted: 04/06/2014] [Indexed: 12/20/2022]
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21
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Venous cystic adventitial disease of the common femoral vein. J Vasc Surg Venous Lymphat Disord 2014; 2:194-6. [DOI: 10.1016/j.jvsv.2013.07.002] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2013] [Revised: 06/24/2013] [Accepted: 07/09/2013] [Indexed: 11/21/2022]
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22
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Venous Cystic Adventitial Disease Presenting as an Enlarging Groin Mass. Ann Vasc Surg 2014; 28:489.e15-8. [DOI: 10.1016/j.avsg.2013.04.019] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2012] [Revised: 03/17/2013] [Accepted: 04/08/2013] [Indexed: 11/18/2022]
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23
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Chen Y, Sun R, Shao J, Li Y, Liu C. A contemporary review of venous adventitial cystic disease and three case reports. Phlebology 2013; 30:11-6. [PMID: 24357449 DOI: 10.1177/0268355513516948] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
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.
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Affiliation(s)
- YueXin Chen
- Department of Vascular Surgery, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China
| | - RuiXue Sun
- Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China
| | - Jiang Shao
- Department of Vascular Surgery, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China
| | - YongJun Li
- Department of Vascular Surgery, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China
| | - ChangWei Liu
- Department of Vascular Surgery, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China
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24
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Mousa AY, Alhalbouni S, Abu-Halimah S, Gill G, Sadek B, Nanjundappa A, Hass SM, AbuRahma AF. Cystic Adventitial Disease of the Common Femoral Vein. Vasc Endovascular Surg 2013; 47:569-72. [PMID: 23873672 DOI: 10.1177/1538574413497110] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
We report on a 52-year-old female patient who presented with a 6-month history of right lower extremity swelling and tenderness. The patient was treated as an outpatient with full anticoagulation, without any improvement. Her medical history was significant for hypertension and high cholesterol, and she had a full coagulopathy profile that was negative for any hypercoagulable syndrome. On examination, the patient was moderately obese, with significant tenderness over the medial aspect of the right groin. A venous duplex examination revealed hypoechoic structure ± acute deep vein thrombosis of right common femoral vein (CFV). A computed tomography of the venous phase revealed an eccentric compression over the medial wall of the right CFV. During surgical exploration, adventitial cystic mucinous disease was enucleated from the medial wall of the right CFV, and the pathological examination confirmed the diagnosis. The postoperative course was uneventful, and all swelling and tenderness were completely resolved. The patient continued to do well, and she had an unremarkable venous duplex evaluation at her 6-month follow-up.
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Affiliation(s)
- Albeir Y. Mousa
- Department of Surgery, Robert C. Byrd Health Sciences Center, West Virginia University, Charleston, WV, USA
- Department of Surgery, Charleston Area Medical Center, Charleston, WV 25304
| | - Saadi Alhalbouni
- Department of Surgery, Robert C. Byrd Health Sciences Center, West Virginia University, Charleston, WV, USA
- Department of Surgery, Charleston Area Medical Center, Charleston, WV 25304
| | - Shadi Abu-Halimah
- Department of Surgery, Robert C. Byrd Health Sciences Center, West Virginia University, Charleston, WV, USA
- Department of Surgery, Charleston Area Medical Center, Charleston, WV 25304
| | - Gurpreet Gill
- Department of Surgery, Robert C. Byrd Health Sciences Center, West Virginia University, Charleston, WV, USA
- Department of Surgery, Charleston Area Medical Center, Charleston, WV 25304
| | - Betro Sadek
- Massachusetts General Hospital, Harvard Medical School Boston, MA, USA
| | - Aravinda Nanjundappa
- Department of Surgery, Robert C. Byrd Health Sciences Center, West Virginia University, Charleston, WV, USA
- Department of Surgery, Charleston Area Medical Center, Charleston, WV 25304
| | - Stephen M. Hass
- Department of Surgery, Robert C. Byrd Health Sciences Center, West Virginia University, Charleston, WV, USA
- Department of Surgery, Charleston Area Medical Center, Charleston, WV 25304
| | - Ali F. AbuRahma
- Department of Surgery, Robert C. Byrd Health Sciences Center, West Virginia University, Charleston, WV, USA
- Department of Surgery, Charleston Area Medical Center, Charleston, WV 25304
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25
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Michaelides M, Papas S, Pantziara M, Ioannidis K. High spatial resolution MRI of cystic adventitial disease of the iliofemoral vein communicating with the hip joint. Cardiovasc Intervent Radiol 2013; 37:271-4. [PMID: 23670571 DOI: 10.1007/s00270-013-0645-8] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/23/2013] [Accepted: 04/15/2013] [Indexed: 12/20/2022]
Abstract
Venous cystic adventitial disease (CAD) is an extremely rare entity, and so far less than 20 cases have been described in the literature. Herein, we describe the imaging findings of CAD of iliofemoral vein in a 51-year-old woman who presented with leg swelling with special emphasis on high spatial resolution MRI, which demonstrated communication of the cyst with the hip joint. To our knowledge, this is the first description of high spatial resolution MRI findings in venous CAD supporting a new theory about the pathogenesis of venous CAD.
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Affiliation(s)
- Michael Michaelides
- MRI/CT Department, Ygia Polyclinic Hospital, 21 Nafpliou Street, P.O. Box 56174, 3305, Limassol, Cyprus,
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26
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Jones DW, Rezayat C, Winchester P, Karwowski JK. Adventitial cystic disease of the femoral vein in a 5-year-old boy mimicking deep venous thrombosis. J Vasc Surg 2012; 55:522-4. [DOI: 10.1016/j.jvs.2011.06.117] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2011] [Revised: 06/28/2011] [Accepted: 06/29/2011] [Indexed: 10/17/2022]
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27
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Paravastu SCV, Regi JM, Turner DR, Gaines PA. A Contemporary Review of Cystic Adventitial Disease. Vasc Endovascular Surg 2011; 46:5-14. [DOI: 10.1177/1538574411419377] [Citation(s) in RCA: 55] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Cystic adventitial disease (CAD) is a rare vascular disorder, predominantly seen in young healthy men with minimal cardiovascular risk factors. Cystic adventitial disease can affect both arteries and veins. Patients with arterial CAD present with sudden onset or rapidly progressing claudication symptoms, and those with venous CAD present with limb swelling or very rarely deep vein thrombosis. Diagnosis is confirmed with the aid of imaging techniques such as ultrasonography, computed tomography, or magnetic resonance scan. Surgical resection or evacuation of the lesion is usually the preferred approach, with only mixed results reported for percutaneous endovascular techniques.
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Affiliation(s)
- Sharath C. V. Paravastu
- Academic Vascular Unit, School of Health and Related Research, University of Sheffield, Sheffield, South Yorkshire, UK
| | - John M. Regi
- Department of Vascular Interventional Radiology, Northern General Hospital, Sheffield, South Yorkshire, UK
| | - Douglas R. Turner
- Department of Vascular Interventional Radiology, Northern General Hospital, Sheffield, South Yorkshire, UK
| | - Peter A. Gaines
- Department of Vascular Interventional Radiology, Northern General Hospital, Sheffield, South Yorkshire, UK
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28
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Drac P, Köcher M, Utikal P, Cerna M, Kozak J, Bachleda P. CYSTIC ADVENTITIAL DISEASE OF THE POPLITEAL ARTERY: REPORT ON THREE CASES AND REVIEW OF THE LITERATURE. Biomed Pap Med Fac Univ Palacky Olomouc Czech Repub 2011; 155:309-21. [DOI: 10.5507/bp.2011.065] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
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29
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In Treatment of Popliteal Artery Cystic Adventitial Disease, Primary Bypass Graft not Always First Choice: Two Case Reports and a Review of the Literature. Eur J Vasc Endovasc Surg 2011; 42:347-54. [DOI: 10.1016/j.ejvs.2011.03.003] [Citation(s) in RCA: 38] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2010] [Accepted: 03/07/2011] [Indexed: 11/24/2022]
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30
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Kwun WH, Suh BY. Adventitial cystic disease of common femoral vein. JOURNAL OF THE KOREAN SURGICAL SOCIETY 2011; 80 Suppl 1:S75-9. [PMID: 22066091 PMCID: PMC3205365 DOI: 10.4174/jkss.2011.80.suppl1.s75] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/29/2010] [Accepted: 10/30/2010] [Indexed: 11/30/2022]
Abstract
Adventitial cystic disease (ACD) of venous system is an extremely rare condition. Very few reports of ACD in venous system have been described. In this report we discuss two cases of common femoral vein ACD that presented with a swollen leg by the obstruction of the vein. Ultrasound imaging showed the typical hypoechoic fluid filled cyst with a posterior acoustic window. Computed tomography scan and ascending venogram showed a stenosis to flow in the common femoral vein caused by an extrinsic mass. Trans-adventitial evacuation of cyst with removal of vein wall was performed for both cases. During operation we found the gelatinous material in the cysts arising in the wall of the common femoral vein and compressing the lumen. The patients were released after short hospitalization and have remained symptom free with no recurrence.
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Affiliation(s)
- Woo-Hyung Kwun
- Department of Surgery, Yeungnam University College of Medicine, Daegu, Korea
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31
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Jayaraj A, Shalhub S, Deubner H, Starnes BW. Cystic Adventitial Disease of the Common Femoral Vein. Ann Vasc Surg 2011; 25:558.e9-11. [DOI: 10.1016/j.avsg.2010.10.016] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2010] [Accepted: 10/15/2010] [Indexed: 11/16/2022]
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32
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Adventitial Cystic Disease of the Femoral Vein. Ann Vasc Surg 2010; 24:1135.e5-7. [DOI: 10.1016/j.avsg.2010.03.007] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2010] [Revised: 03/01/2010] [Accepted: 03/15/2010] [Indexed: 11/20/2022]
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33
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Abstract
Apesar de sua raridade, a doença cística da artéria poplítea (DCAP) deve ser lembrada no diagnóstico diferencial de claudicação intermitente de membros inferiores em pacientes jovens. A literatura brasileira apresenta poucos relatos dessa doença. Este trabalho reportou o caso de um paciente masculino portador de DCAP e revisou a literatura, traçando um paralelo com a síndrome de aprisionamento da artéria poplítea.
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34
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Maged IM, Turba UC, Housseini AM, Kern JA, Kron IL, Hagspiel KD. High spatial resolution magnetic resonance imaging of cystic adventitial disease of the popliteal artery. J Vasc Surg 2010; 51:471-4. [DOI: 10.1016/j.jvs.2009.08.079] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2009] [Revised: 08/25/2009] [Accepted: 08/25/2009] [Indexed: 10/19/2022]
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35
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Johnson JM, Kiankhooy A, Bertges DJ, Morris CS. Percutaneous Image-Guided Aspiration and Sclerosis of Adventitial Cystic Disease of the Femoral Vein. Cardiovasc Intervent Radiol 2009; 32:812-6. [DOI: 10.1007/s00270-009-9581-z] [Citation(s) in RCA: 27] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/02/2008] [Revised: 01/26/2009] [Accepted: 04/07/2009] [Indexed: 11/30/2022]
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36
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Seo JY, Chung DJ, Kim JH. Adventitial cystic disease of the femoral vein: a case report with the CT venography. Korean J Radiol 2009; 10:89-92. [PMID: 19182509 PMCID: PMC2647180 DOI: 10.3348/kjr.2009.10.1.89] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Fewer than 20 cases of adventitial cystic disease of the vein have been reported in the worldwide literature. This small number of reported cases may be due not only to the disease's low incidence, but also to the difficulty in making the proper diagnosis. Many techniques have been used to investigate this disease, but venography has been the traditional diagnostic tool. In this report we present a case of adventitial cystic disease that was well demonstrated by CT venography.
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Affiliation(s)
- Jae Young Seo
- Department of Radiology, University of Konyang College of Medicine, Daejeon, Korea
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37
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