Successful Surgical Resection and Reconstruction for Symptomatic Popliteal Artery Cystic Adventitial Disease: 2-year Follow-up

Cystic adventitial disease (CAD) is a rare vascular condition characterized by mucinous cyst formation within the adventitial layer of arteries, which can obstruct blood flow and lead to symptoms such as intermittent claudication. This case report describes a 44-year-old woman who presented with typical intermittent calf claudication and no significant prior medical history. Arterial Doppler ultrasound revealed a hypoechoic lesion surrounding the popliteal artery, suggestive of extrinsic compression and significant luminal stenosis. Computed tomography angiography confirmed the diagnosis of CAD involving the left popliteal artery. The patient underwent complete surgical excision of the cyst and arterial reconstruction using an interposition vein graft. Her postoperative course was uneventful, and she remained symptom-free at her 2-year follow-up, with no evidence of recurrence. CAD is estimated to represent approximately 0.1% of vascular disorders, more commonly affecting middle-aged men. The condition often requires surgical intervention due to its progressive nature and unclear etiology. Despite its rarity, CAD should be considered in young patients presenting with vascular insufficiency in the absence of atherosclerotic risk factors.