Hennessy Mairead M, McGreal Gerald, O'Brien Gavin C
1 Department of General and Vascular Surgery, Mercy University Hospital, Cork, Ireland.
Vasc Endovascular Surg. 2017 Oct;51(7):480-484. doi: 10.1177/1538574417722921. Epub 2017 Sep 1.
Cystic adventitial disease (CAD) is a rare vascular pathology which predominantly affects peripheral vessels of young otherwise healthy males. Much debate exists regarding its exact etiology. It is characterized by a collection of mucinous material within the adventitial wall layer of the affected vessel, resulting in arterial stenosis and rapidly progressive calf claudication. Treatment is primarily surgical, although radiological interventions have been reported. Its rarity makes evidence-based surgical or radiological management difficult. With this in mind, we report two cases of popliteal artery CAD treated successfully with primary excision and bypass grafting. We analyzed all literature published on CAD since first reported in 1947 and we propose an algorithm for appropriate management pathways.
囊性外膜疾病(CAD)是一种罕见的血管病变,主要影响年轻健康男性的外周血管。关于其确切病因存在诸多争议。其特征是在受累血管的外膜壁层内有粘液性物质积聚,导致动脉狭窄和迅速进展的小腿间歇性跛行。治疗主要是手术治疗,尽管也有放射介入治疗的报道。其罕见性使得基于证据的手术或放射治疗管理变得困难。考虑到这一点,我们报告了两例经初次切除和旁路移植术成功治疗的腘动脉CAD病例。我们分析了自1947年首次报道以来发表的所有关于CAD的文献,并提出了一种适当管理途径的算法。