Sassi Farah, Azouz Heifa, Hermes Sahbi, Zehani Alia, Haouet Slim
Pathology Department, Rabta hospital, Tunis, Tunisia.
Pathology Department, Rabta hospital, Tunis, Tunisia.
Int J Surg Case Rep. 2024 Apr;117:109541. doi: 10.1016/j.ijscr.2024.109541. Epub 2024 Mar 19.
Cystic adventitial disease (CAD) is a rare vascular disorder marked by occlusion stemming from the development of a cystic mass within the outer (subadventitial) layer, with a predominant impact on the popliteal artery. The significance of the case presented herein lies in shedding light on a distinct clinical manifestation involving a 40-year-old man who exhibited sporadic calf claudication during ambulation. This instance contributes to the broader understanding of CAD and its diverse clinical presentations, emphasizing the need for further exploration and awareness within the medical community.
A 40-year-old man, with no significant past medical history, was referred to the cardiovascular department for the evaluation of a new onset of left calf pain persisting over the past three months. An arterial lower limb Doppler ultrasound was performed, revealing a focal hypoechoic image around the popliteal artery with a regular arterial wall, indicative of extrinsic compression. This resulted in significant stenosis of the popliteal artery during plantar flexion of the foot. The diagnosis of CAD of the left popliteal artery was established after limb computed tomography angiography, and a complete resection of the cyst was scheduled. The postoperative course was uneventful, with the patient experiencing relief from left calf claudication.
CAD is an uncommon vascular anomaly, representing merely 0.1 % of all vascular conditions. This condition predominantly afflicts men aged between 40 and 50 years old. The etiology of CAD remains a subject of debate, with pathological findings typically involving intramural cysts containing gelatinous material between the media and the adventitia. Surgical intervention becomes necessary when symptoms arise.
CAD of the popliteal artery, though rare, is a significant contributor to peripheral vascular insufficiency in young patients without typical atherosclerotic risk factors.
囊性外膜疾病（CAD）是一种罕见的血管疾病，其特征是由于在外膜（外膜下）层形成囊性肿块而导致血管闭塞，主要影响腘动脉。本文所呈现病例的意义在于揭示了一名40岁男性在行走时出现间歇性小腿跛行这一独特的临床表现。该病例有助于更广泛地理解CAD及其多样的临床表现，强调了医学界进一步探索和提高认识的必要性。
一名40岁男性，既往无重大病史，因过去三个月持续出现的左小腿疼痛新发症状被转诊至心血管科。进行了下肢动脉多普勒超声检查，结果显示腘动脉周围有局灶性低回声图像，动脉壁规则，提示存在外部压迫。这导致在足部跖屈时腘动脉出现明显狭窄。经肢体计算机断层扫描血管造影后确诊为左腘动脉CAD，并计划对囊肿进行完整切除。术后过程顺利，患者左小腿跛行症状缓解。
CAD是一种罕见的血管异常，仅占所有血管疾病的0.1%。这种疾病主要影响40至50岁的男性。CAD的病因仍存在争议，病理检查结果通常显示在中膜和外膜之间存在含有胶冻样物质的壁内囊肿。当出现症状时，手术干预是必要的。
腘动脉CAD虽然罕见，但在没有典型动脉粥样硬化危险因素的年轻患者中，是导致周围血管功能不全的重要原因。
