Jornal Vascular Brasileiro
https://jvascbras.org/article/doi/10.1590/S1677-54492012000200012
Jornal Vascular Brasileiro
Therapeutic Challenge

Isquemia crítica em membro inferior em paciente jovem com doença cística de artéria poplítea

Critical limb ischemia in a young patient with cystic disease of the popliteal artery

Michel Nasser; Luca Giovanni Antonio Pivetta; José Luis Teixeira Filho; Evelin Schueteze Rocha; Ana Eliza Botta

http://dx.doi.org/10.1590/S1677-54492012000200012 J Vasc Bras, vol.11, n2, p.144-149, 2012
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Resumo

Degeneração cística da artéria poplítea é uma doença vascular rara, de etiologia desconhecida, na qual um cisto com conteúdo mucinoide compromete a artéria e desenvolve estenose ou oclusão do vaso. Apresentamos um caso de um paciente do sexo masculino, 45 anos, admitido na emergência hospitalar, que apresentava quadro de isquemia aguda no membro inferior esquerdo. Submetido à EcoDoppler, angiorressonância magnética e angiografia pré-operatória. Realizada arterectomia com enxerto fêmoro-poplíteo infrainguinal de safena invertida. O exame patológico foi consistente com o diagnóstico de doença cística da artéria poplítea. O paciente encontra-se em acompanhamento ambulatorial e foi acometido pela doença cística no membro contralateral. Os autores descreveram os melhores métodos de diagnóstico e tratamento para a doença, discutindo se o procedimento de urgência foi o mais adequado e se haveria opções terapêuticas alternativas para o caso, além de qual seria a melhor conduta a ser realizada no membro contralateral também acometido pela doença.

Palavras-chave

claudicação intermitente, cisto, artéria poplítea

Abstract

Cystic adventitial disease of the popliteal artery is a rare vascular disease of unknown etiology in which a mucin-containing cyst may compromise the artery and, because of the compression, develops stenosis or occlusion of affected artery. We report the case of a 45-year-old male with cystic adventitial disease of the left popliteal artery, after admission for an acute limb ischemia in his left leg, diagnosed non-invasively with EcoDoppler vascular dual scan, magnetic resonance angiography, angiography. Performed complete removal of the cyst with arteriectomy and venous replacement. The pathologic result ware consistent with the diagnostic of cystic adventitial disease. The patient is in ambulatory follow up and was affected by cystic disease in the contralateral limb. The authors described the best methods of diagnosis and treatment for cystic adventitial disease, discussing if the urgency procedure was the most appropriate and whether there was an alternative treatment for the case. Finally, questioning what would be the best procedure to be performed in the other limb.

Keywords

intermittent claudication, cyst, popliteal artery

References

Alder VW, Zwicker H. The diagnosis of cystic degeneration of the adventitia. Rofo. 1977;126(4):331-4.

Bergan JJ. Adventitial cystic disease of the popliteal artery. Vascular Surgery. 1977.

Terry JD, Schenken JR, Lohff MR, Neis DD. Cystic adventitial disease. Hum Pathol. 1981;12(7):639-42.

Lassalle C, Paquis M, Florquet J, Mathieu P, Frisch R. Kyste colloide de I'adventice de l'aertère poplitée: A propos de trois cas. Ann Med Nancy. 1978;17:575-7.

Müller M, Rodriguéz J. Obstrucción de lá arteria poplitea por enfermedad quística mucinosa de la pared arterial. Angiologia. 1975;27(1):1-6.

Blum L, Giron F. Adventitial cyst of the popliteal artery with secondary inflammatory entirapment. Mt Sinai J Med Ny. Mt Sinai J Med. 1976;43(4):471-5.

Rollo HA, Gama JCFD, Lastória S, Yoshida WB, Maffei FH. Cisto de adventícia em artéria poplítea: Relato de dois casos. AMB Rev Ass Med Bras. 1982;28:79-81.

Bakstrom CG, Linell F, Östberg B. Cystic, mixomatous adventitial degeneration of the radial artery with development of ganglion in the connective tissue: Report of two cases. Acta Chir Scand. 1965;129:447-51.

Miranda Junior F, Francisco Jr J, Burihan E. Cisto de artéria poplítea. Rev Bras Cir. 1982;72(4):221-2.

Albernaz DTS, Albernaz LFL, Eggers EE. Doença cística da artéria poplítea: relato de caso. J Vasc Bras. 2010;9(3):168-72.

Lie JT, Juergens JL. Degenerative arterial disease other than atherosclerosis. Allen-Barker-Hines Peripheral Vascular Diseases. 1980:237-53.

Shute K, Rothnie NG. The aetiology of cystic arterial disease. Br J Surg. 1973;60:397-400.

Mark TM, Rywlin AM, Unger H. Cystic adventitial degeneration of the popliteal artery: Its occurence in a patient with the nail-patella syndrome. Arch Pathol Lab Med. 1983;107:186-8.

Flanigan DP, Burnharn SJ, Goodreau JJ, Bergan JJ. Summary of cases of adventitial cystic disease of the popliteal artery. Ann Surg. 1979;189:165-75.

Bourke BM, Appleberg M, Reeve TS, Hollings RM. Cystic adventitial disease of the popliteal artery: A report of two cases and a review of the literature. Aust N Z J Surg. 1982;52(2):171-3.

Lewis GJT, Douglas DM, Reid W, Watt JK. Cystic adventitial disease of the popliteal artery. Br Med. 1967;60:411-5.

Ishikawa K. Cystic adventitial disease of the popliteal artery and of other stem vessels in the extremities. Jpn J Surg. 1987;17:221-9.

Maffei FHA, Barbosa AG, Rollo HA, Neser A, Lastoria S. Adventitial cystic disease of the popliteal artery in Brazil: additional data on the geographical distribution of the disease. Angiology. 1982;33:339-42.

Stapff M, Zoller W, Spengel F. Image-directed Doppler ultrasound findings in adventitial cystic disease of the popliteal artery. J Clin Ultrasound. 1989;17:689-91.

Rizzo RJ, Flinn WR, Yao JS, McCarthy WJ, Vogelzang RL, Pearce WH. Computed tomography for evaluation of arterial disease in the popliteal fossa. J Vasc Surg. 1990;11(1):112-9.

Crolla RMPH, Steyling JF, Hennipman A, Slootweg PJ, Taams A. A case of cystic adventitial disease of the popliteal artery demonstrated by magnetic resonance imaging. J Vasc Surg. 1993;18:1052-5.

Miller A, Salenius J, Sacks BA, Gupta SK, Shoukimas GM. Noninvasive vascular imaging in the diagnosis and treatment of adventitial cystic disease of the popliteal artery. J Vasc Surg. 1997;26:715-20.

Maged IM, Turba UC, Housseini AM, Kern JA, Kron IL, Hagspiel KD. High spatial resolution magnetic resonance imaging of cystic adventitial disease of the popliteal artery. J Vasc Surg. 2010;51:471-4.

Ortiz M WR, Lopera JE, Giménez CR, Restrepo S, Moncada R, Castañeda-Zúñiga WR. Bilateral adventitial cystic disease of the popliteal artery: a case report. Cardiovasc Intervent Radiol. 2006;29:306-10.

Rai S, Davies RS, Vohra RK. Failure of endovascular stenting for popliteal cystic disease. Ann Vasc Surg. 2009;23(410):e1-e5.

Do DD, Braunschweig M, Baumgartner I, Furrer M, Mahler F. Adventitial cystic disease of the popliteal artery: percutaneous US-guided aspiration. Radiology. 1997;203:743-6.

Maged IM, Kron IL, Hagspiel KD. Recurrent cystic adventitial disease of the popliteal artery: successful treatment with percutaneous transluminal angioplasty. Vas Endovasc Surg. 2009;43:399-402.

Sieunarine K, Lawrence-Brown MM, Kelsey P. Adventitial cystic disease of the popliteal artery: early recurrence after CT guided percutaneous aspiration. J Cardiovasc Surg. 1991;32(5):702-4.

Mellière D, Ecollan P, Kassab M, Becqemin JP. Adventitial cystic disease of the popliteal artery: treatment by cyst removal. J Vasc Surg. 1988;8(5):638-42.

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