Drac Petr, Köcher Martin, Utikal Petr, Cerna Marie, Kozak Jiri, Bachleda Petr
Department of Surgery II - Vascular and Transplantation Surgery, University Hospital Olomouc, Czech Republic.
Biomed Pap Med Fac Univ Palacky Olomouc Czech Repub. 2011 Dec;155(4):309-21. doi: 10.5507/bp.2011.065.
During the past nine years three cases of cystic adventitial disease of the popliteal artery have been diagnosed and treated in our medical institution. Different approaches were used in the treatment in all these cases. The purpose of this report is to summarise the current knowledge of the etiology, presentation, diagnostics and treatment of this condition, with the addition of new cases.
Information about three new cases is presented and discussed together with that from the relevant publications obtained from the Pubmed database. Results. In the first case resection with synthetic graft interposition was used. Nine years after the surgery the patient is without any signs of recurrence, but he experienced local thrombolysis of the occluded graft and repeated PTA of hemodynamically significant anastomotic stenoses. The second case treated with US-guided aspiration has demanded repeated reinterventions due to recurrence; nevertheless, the result is satisfactory. In the last instance, the cyst was evacuated and excised. Six months after the surgery the patient is symptom-free and without signs of recurrence.
CAD of the popliteal artery is a rare vascular condition. However, it must be considered in the differential diagnosis, especially in middle-aged male patients without evidence of atherosclerotic disease in whom intermittent claudication has developed suddenly with a rapid progression or with fluctuation in severity. Duplex ultrasound and MRA are the the best diagnostic methods. Based on the existing knowledge, the treatment of choice is surgery (either evacuation with the removal of the cystic wall or resection and grafting).
在过去九年中，我们医疗机构诊断并治疗了三例腘动脉囊性外膜疾病。所有这些病例均采用了不同的治疗方法。本报告的目的是总结关于这种疾病的病因、表现、诊断和治疗的现有知识，并补充新病例。
介绍并讨论了三例新病例的信息，以及从PubMed数据库获得的相关出版物中的信息。结果。第一例采用人工血管置换术切除。术后九年，患者无任何复发迹象，但出现了人工血管局部血栓形成，对血流动力学意义重大的吻合口狭窄进行了反复经皮腔内血管成形术（PTA）。第二例采用超声引导下抽吸治疗，因复发需要反复再次干预；尽管如此，结果令人满意。最后一例，囊肿被排空并切除。术后六个月，患者无症状且无复发迹象。
腘动脉囊性外膜疾病是一种罕见的血管疾病。然而，在鉴别诊断中必须考虑到它，特别是在没有动脉粥样硬化疾病证据的中年男性患者中，这些患者突然出现间歇性跛行，且进展迅速或严重程度有波动。双功超声和磁共振血管造影（MRA）是最佳诊断方法。根据现有知识，首选治疗方法是手术（要么排空囊肿并切除囊壁，要么切除并移植）。
