TY - JOUR
T1 - Cystic adventitial pathology as an entity in peripheral arterial disease
AU - Lejay, Anne
AU - Ohana, Mickael
AU - Delay, Ckarline
AU - Georg, Yannick
AU - Girsowicz, Elie
AU - Thaveau, Fabien
AU - Scholey, James W.
AU - Geny, Bernard
AU - Chakfe, Nabil
PY - 2016/4
Y1 - 2016/4
N2 - BACKGROUND: Cystic adventitial disease (CAD) is a rare condition in which mucinous cyst forms within the adventitia of arteries and veins. The management of CAD still remains unclear and a wide range of imaging and treatment options has been described. The purpose of this study is to propose an update of etiology, clinical diagnosis, imaging modalities and treatment options in the setting of CAD described on arterial territory. METHODS: We performed a systematic review including studies reporting case or case series of CAD, searching across the Medline, Embase and Cochrane databases. RESULTS: We identified 513 reports and 677 arterial cysts. Various imaging modalities such as Duplex ultrasonography, magnetic resonance imaging, computed tomographic angiography and conventional angiography were included. A wrde range of treatment options have been performed with the most common being cyst resection followed by saphenous vein graft reconstruction in 259 cases. Follow-up was described in 431 cases with an average of 33 months. There were 51 patients who developed cyst recurrence. Among the 102 cases where joint connection was identified, 40 had either ligation of the joint connection or joint resection, which led to no recurrences. CONCLUSIONS: CAD must be considered as en entity in peripheral arterial disease and considered in the differential diagnosis, in particular for middle-aged male patients who show no evidence of atherosclerotic disease. A better understanding of the pathogenesis of CAD will allow a consensus on treatment strategy and improve outcomes by reducing recurrence rates.
AB - BACKGROUND: Cystic adventitial disease (CAD) is a rare condition in which mucinous cyst forms within the adventitia of arteries and veins. The management of CAD still remains unclear and a wide range of imaging and treatment options has been described. The purpose of this study is to propose an update of etiology, clinical diagnosis, imaging modalities and treatment options in the setting of CAD described on arterial territory. METHODS: We performed a systematic review including studies reporting case or case series of CAD, searching across the Medline, Embase and Cochrane databases. RESULTS: We identified 513 reports and 677 arterial cysts. Various imaging modalities such as Duplex ultrasonography, magnetic resonance imaging, computed tomographic angiography and conventional angiography were included. A wrde range of treatment options have been performed with the most common being cyst resection followed by saphenous vein graft reconstruction in 259 cases. Follow-up was described in 431 cases with an average of 33 months. There were 51 patients who developed cyst recurrence. Among the 102 cases where joint connection was identified, 40 had either ligation of the joint connection or joint resection, which led to no recurrences. CONCLUSIONS: CAD must be considered as en entity in peripheral arterial disease and considered in the differential diagnosis, in particular for middle-aged male patients who show no evidence of atherosclerotic disease. A better understanding of the pathogenesis of CAD will allow a consensus on treatment strategy and improve outcomes by reducing recurrence rates.
KW - Adventitia
KW - Peripheral arterial disease
KW - Vascular surgical procedures
KW - Ysts
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M3 - Article
C2 - 26471959
AN - SCOPUS:84977444153
VL - 57
SP - 282
EP - 291
JO - Journal of Cardiovascular Surgery
JF - Journal of Cardiovascular Surgery
SN - 0021-9509
IS - 2
ER -