title: Cystic adventitial degeneration of the popliteal artery: report on 3 cases and review of the literature.
abstract: BACKGROUND
  Cystic adventitial disease (CAD) is a rare, nonatherosclerotic vascular condition predominantly seen in middle-aged men with no cardiovascular risk factors. Three cases have been diagnosed and treated in our institution during the past 8 years. The purpose of this report is to provide an updated literature review of this condition with the addition of 3 new cases.
  
  
  METHODS
  Information about 3 new cases is presented along with data obtained from articles published between 1979 and 2012 from PubMed and Embase databases. Two hundred thirty-eight articles were found, and 98 were included in our review.
  
  
  RESULTS
  All patients treated presented with rapidly progressive intermittent calf claudication. Diagnosis of CAD was confirmed by at least 2 imaging techniques, either duplex ultrasound or magnetic resonance imaging, with a preoperative angiography performed in all cases. Wall cyst resection was performed in the 3 cases reported here, after intraoperative confirmation that there was no arterial wall damage. All patients remained asymptomatic with no signs of recurrence after a median 36-month follow-up (24-60 month follow-up).
  
  
  CONCLUSIONS
  CAD is a rare vascular condition usually affecting arteries that presents as a sudden onset of unilateral intermittent calf claudication. Diagnosis must be confirmed with imaging techniques, such as duplex ultrasonography and magnetic resonance imaging. On the basis of existing knowledge, surgery remains the treatment of choice, with cystic evacuation in cases with no arterial wall damage or resection and grafting. However, the follow-up algorithm for treated patients remains unclear.
authors: Servicio de Angiología y Cirugía Vascular, Hospital Clínico San Carlos, Madrid, Spain. Electronic address: manuelahdez@hotmail.com.
authors: Manuela M
authors: MM
authors: Hernández Mateo
authors: Servicio de Angiología y Cirugía Vascular, Hospital Clínico San Carlos, Madrid, Spain.
authors: Francisco J
authors: FJ
authors: Serrano Hernando
authors: Servicio de Angiología y Cirugía Vascular, Hospital Clínico San Carlos, Madrid, Spain.
authors: Isaac
authors: I
authors: Martínez López
authors: Servicio de Angiología y Cirugía Vascular, Hospital Clínico San Carlos, Madrid, Spain.
authors: Sara
authors: S
authors: González Sánchez
authors: Servicio de Angiología y Cirugía Vascular, Hospital Clínico San Carlos, Madrid, Spain.
authors: Manuel
authors: M
authors: Hernando Rydings
authors: Servicio de Angiología y Cirugía Vascular, Hospital Clínico San Carlos, Madrid, Spain.
authors: Ana
authors: A
authors: Saiz Jerez
authors: Servicio de Angiología y Cirugía Vascular, Hospital Clínico San Carlos, Madrid, Spain.
authors: Sergio
authors: S
authors: Revuelta Suero
authors: Servicio de Angiología y Cirugía Vascular, Hospital Clínico San Carlos, Madrid, Spain.
authors: Pablo
authors: P
authors: Marqués de Marino
mesh_terms: D063194:Adventitia / Q000000981:diagnostic imaging / Q000473:pathology / Q000601:surgery; D003560:Cysts / Q000175:diagnosis / Q000601:surgery; D005260:Female; D006801:Humans; D007383:Intermittent Claudication / Q000175:diagnosis / Q000601:surgery; D018810:Magnetic Resonance Angiography; D008297:Male; D008875:Middle Aged; D064847:Multimodal Imaging / Q000379:methods; D011150:Popliteal Artery / Q000000981:diagnostic imaging / Q000473:pathology / Q000601:surgery; D011237:Predictive Value of Tests; D011859:Radiography; D016896:Treatment Outcome; D018616:Ultrasonography, Doppler, Duplex; D014652:Vascular Diseases / Q000175:diagnosis / Q000601:surgery