Cystic adventitial disease of the popliteal artery: radical surgical treatment after several failed approaches. A case report and Review of the Literature

ABSTRACT Adventitial cystic disease is a rare non-atheromatous cause of popliteal artery disease. We report the case of a 49 years old male patient who presented with left calf claudication caused by adventitial cystic disease. Popliteal artery resection followed by autologous vein graft interposition and Percutaneous Transluminal Angioplasty (PTA)-stenting yielded to recurrence. The patient was finally successfully treated by bypass with autologous vein. No postoperative complications occurred, and patency was preserved at thirty-three-month follow-up. Several different treatment options are possible, however a primary radical surgical treatment with extra-anatomical medial bypass with autologous vein seems preferable.