Cystic adventitial disease of popliteal artery with significant stenosis
A 40-year-old male patient presented with complaints of intermittent claudication in the right lower limb for past 6 months. There was no history of fever, trauma, diabetes mellitus, or hypertension. He was an occasional smoker. There were no other significant associated complaints. Physical examination revealed diminished pulses in right lower limb arteries, for which Doppler USG (ultrasound) examination was requested. Doppler study revealed multiloculated cystic lesion in relation to the popliteal artery, causing significant luminal narrowing with dampened low resistance flow in distal arteries []. It was also causing focal narrowing of popliteal vein. Subsequently, the patient underwent computed tomography angiography (CTA) on 128-slice multidetector computed tomography (MDCT) scanner (Ingenuity CT, Philips Healthcare, Cleveland, OH, USA). CTA revealed multiloculated cystic lesion in relation to right popliteal artery, with mild peripheral enhancement. There was significant focal eccentric narrowing of popliteal artery. Distal vessels were normally opacified. It was also causing narrowing of popliteal vein []. Based on the characteristic imaging findings, diagnosis of cystic adventitial disease of popliteal artery was made. Patient underwent surgery with partial resection of the cysts and the diagnosis was confirmed on histopathology. Patient improved symptomatically. Postoperative CTA revealed significant reduction of cystic disease and reduction of popliteal artery stenosis [].