Cystic Adventitial Disease of the Popliteal Artery: Radical Surgical Treatment After Several Failed Approaches. A Case Report and Review of the Literature.

Adventitial cystic disease is a rare nonatheromatous cause of popliteal artery disease. We report the case of a 49-year-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 led to recurrence. The patient was finally successfully treated by bypass with autologous vein. No postoperative complications occurred, and patency was preserved at 33-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.