RESECTION IN ADVENTITIAL CYSTIC-DISEASE O F THE POPLITEAL ARTERY

Adventitial cystic disease is a rare form of non-atherosclerotic steno sis of the popliteal artery. It is caused by synovial-like cysts in th e subadventitial tissue layer of the arterial wall causing compression of the lumen. The cysts contain mucinous material similar to that fou nd in joint-ganglia. Popliteal artery stenoses causing claudication in young patients is the leading symptom of this disease. The classical therapy is the surgical excision of the diseased artery and interposit ion grafting with saphenous vein. As an alternative method we present the technique of complete circumferential resection of the diseased ad ventitia to deompress the lumen of the artery by removing the cysts co mpletely. This technique is called exarterectomy and has been applied in 2 patients. In both cases we could remove the cysts completely with out opening the arterial lumen. Intraoperative arteriography documente d complete decompression of the arterial lumen. Both patients presente d with excellent results 6 months postoperatively without any symptoms or signs of recurrence. Late results of exarterectomy ar not yet avai lable.