Ultrasound-guided percutaneous aspiration as an alternative method of treatment for Adventitial Cystic Disease: A case series

Adventitial cystic disease (ACyD) is a rare vascular condition, first documented in 1947, representing approximately 0.1 % of vascular disorders, most commonly affecting the popliteal artery. The condition presents primarily with symptoms of intermittent claudication. Traditional treatment options include cyst excision, arterial segment removal with vein graft reconstruction, or percutaneous aspiration. This publication reports on the results of three patients diagnosed with ACyD (males 66 %, mean age 46 years old) and treated with ultrasound-guided percutaneous aspiration (UGPA) as the initial approach. The patients were recruited over a five-year period in two private hospitals and their main symptom was claudication (Rutherford 2 and 3). The main symptom was intermittent claudication. All three patients were succesfully treated with UGPA (100 % technical success) and reported immediate increase of their walking distance and total resolution of claudication. All patients remain symptom-free at 15.7 months (range 7-30). No additional procedures were necessary. Ultrasound-guided percutaneous aspiration for ACyD appears to be a safe and effective initial treatment that restores blood flow in affected vessels. Further long-term follow-up is necessary to establish the durability of the treatment outcomes.