Adventitial cystic disease of the popliteal artery: percutaneous US-guided aspiration.

PURPOSE

To evaluate percutaneous ultrasound (US)-guided aspiration as an alternative therapy for adventitial cystic disease.

MATERIALS AND METHODS

Between September 1993 and June 1996, seven patients (six men, one woman; age range, 42-62 years; mean age, 48 years) presented with symptomatic adventitial cystic disease of the popliteal artery (one patient with subacute foot paresthesia, six patients with chronic calf claudication). Color Doppler sonography showed stenosis due to eccentric cysts. Five of the patients also underwent digital subtraction angiography, and four patients underwent magnetic resonance imaging. With real-time sonographic guidance, a 14-gauge needle was forwarded percutaneously into the cysts for aspiration. The aspiration procedure was performed on an outpatient basis with local anesthetics.

RESULTS

The procedure was technically and clinically successful in all cases. No complications were noted. Follow-up color duplex sonography performed between 1 and 32 months (mean, 14.8 months) after the procedure showed no relevant recurrent stenosis.

CONCLUSION

Percutaneous US-guided aspiration is an easy, safe, efficacious method for treating adventitial cystic disease. In symptomatic patients who do not have thrombotic occlusion, it may be considered the treatment of choice.