Percutaneous image-guided aspiration and sclerosis of adventitial cystic disease of the femoral vein.
Adventitial cystic disease (ACD), also known as cystic mucoid or myxomatous degeneration, is a rare vascular disease mainly seen in arteries. Seventeen cases have been reported in the world literature. We report the first known case of ACD successfully treated with percutaneous image-guided ethanol sclerosis. Computed tomography showed a cystic mass adherent to the wall of the common femoral vein. An ultrasound examination revealed a deep venous thrombosis of the leg, secondary to extrinsic compression of the common femoral vein. Three years prior to our procedure, the cyst was aspirated, which partially relieved the patient's symptoms. Over the following 3 years the patient's symptoms worsened and a 10-cm discrepancy in thigh size developed, in addition to the deep venous thrombosis associated with lower-extremity edema. Using ultrasound guidance and fluoroscopic control, the cyst was drained and then sclerosed with absolute ethanol. The patient's symptoms and leg swelling resolved completely within several weeks. Follow-up physical examination and duplex ultrasound 6 months following sclerosis demonstrated resolution of the symptoms and elimination of the extrinsic compression effect of the ACD on the common femoral vein.
Johnson
Jason M
JM
Section of Interventional Radiology, Department of Radiology, University of Vermont College of Medicine, Fletcher Allen Health Care, 111 Colchester Avenue, Burlington, VT 05401, USA.
Kiankhooy
Armin
A
Bertges
Daniel J
DJ
Morris
Christopher S
CS
D000368:Aged; D003560:Cysts / Q000000981:diagnostic imaging / Q000628:therapy*; D000431:Ethanol / Q000627:therapeutic use; D005268:Femoral Vein; D006801:Humans; D008297:Male; D016491:Peripheral Vascular Diseases / Q000000981:diagnostic imaging / Q000628:therapy*; D012008:Recurrence; D012597:Sclerosing Solutions / Q000627:therapeutic use; D015911:Sclerotherapy / Q000379:methods*; D013396:Suction; D014057:Tomography, X-Ray Computed; D018084:Ultrasonography, Interventional
D012597:Sclerosing Solutions; D000431:Ethanol