Setoguchi Akito, Kusumoto Saburo, Hashizume Koji, Irie Junji, Maemura Koji
Department of Cardiovascular Medicine, Nagasaki Harbor Medical Center, Nagasaki, JPN.
Department of Cardiovascular Surgery, Nagasaki Harbor Medical Center, Nagasaki, JPN.
Cureus. 2025 Mar 26;17(3):e81263. doi: 10.7759/cureus.81263. eCollection 2025 Mar.
Adventitial cystic disease (ACD) of the popliteal artery is a rare disease that can cause intermittent claudication, and most cases show cysts located in the adventitia. We report a rare case with a cyst localized in the media and a dissection. The patient presented to the hospital with sudden-onset right lower limb pain. A lower limb ultrasound revealed an iso-echoic lesion in the right popliteal artery, leading to an initial diagnosis of thrombotic occlusion and subsequent thrombectomy. However, intravascular ultrasound suggested the lesion was outside the intima, and magnetic resonance imaging findings indicated ACD. Consequently, cyst resection with expanded polytetrafluoroethylene (ePTFE) graft reconstruction was performed. Histopathological examination revealed dissection associated with cystic medial necrosis. However, the condition was diagnosed as cystic arterial disease due to its similarity to previously reported cases and the inadequacy of the term "adventitial" cystic disease.
腘动脉外膜囊肿性疾病（ACD）是一种罕见疾病，可导致间歇性跛行，且大多数病例显示囊肿位于外膜。我们报告1例罕见病例，囊肿位于中膜并伴有夹层。该患者因突发右下肢疼痛入院。下肢超声显示右腘动脉有等回声病变，初步诊断为血栓闭塞并随后进行了血栓切除术。然而，血管内超声提示病变在内膜外，磁共振成像结果提示为ACD。因此，进行了囊肿切除并采用膨体聚四氟乙烯（ePTFE）移植物重建。组织病理学检查显示夹层与囊性中膜坏死相关。然而，由于其与先前报道病例相似且“外膜”囊肿性疾病这一术语并不恰当，故该疾病被诊断为囊性动脉疾病。
