Doppler ultrasonography and exercise testing in diagnosing a popliteal artery adventitial cyst.
We describe popliteal arterial adventitial cystic disease which causes intermittent claudication in a young athletic man, with atypical manifestation, without loss of foot pulses on knee flexion nor murmur in the popliteal fossa. The findings obtained from Magnetic Resonance Imaging were non-diagnostic. The diagnosis resulted from Echo-Doppler ultrasonography along with peak exercise testing. Ultrasonography also provided useful physiopathological informations suggesting that a popliteal artery adventitial cyst can become symptomatic if muscle exertion increases fluid pressure within the cyst, enough to cause hemodynamically significant endoluminal stenosis. Rapid diagnosis is essential to prevent progressive claudication threatening limb viability. To guarantee this professional sportsman a reliable and durable outcome, instead of less aggressive management, we resected the involved arterial segment and interposed an autologous saphenous-vein graft.
Taurino
Maurizio
M
Department of Vascular Surgery, University of Rome La Sapienza, II Medical School, S, Andrea Hospital, Roma, Italy. maurizio.taurino@uniroma1.it
Rizzo
Luigi
L
Stella
Nazzareno
N
Mastroddi
Massimo
M
Conteduca
Fabio
F
Maggiore
Claudia
C
Faraglia
Vittorio
V
D000328:Adult; D005080:Exercise Test; D006801:Humans; D008297:Male; D016491:Peripheral Vascular Diseases / Q000000981:diagnostic imaging*; D011150:Popliteal Artery / Q000000981:diagnostic imaging*; D011151:Popliteal Cyst / Q000000981:diagnostic imaging*; D018608:Ultrasonography, Doppler / Q000379:methods*