Cystic adventitial degeneration of the popliteal artery - the diagnostic value of duplex sonography

Cystical adventitial degeneration of the popliteal artery is a disorder whi ch is difficult to diagnose, due to the similarity of the symptoms of peopl e presenting with peripheral arterial occlusive disease (PAOD) or popliteal entrapment syndrome. The only thing that differs from patients suffering f rom PAOD is the lack of typical risk factors for arteriosclerosis. Typical diagnostic procedures like conventional angiography or magnetic resonance I maging angiography can be negative, too and therefore misleading. The only which is crucial in the diagnosis of cystic adventitial degeneration of the popliteal artery is to know the morphological background of this disorder, namely that it is a cyst of the adventitia of the artery which leads to a dynamic exercise-dependent flow inhibition. We present a 57-year old white male who had a week's history of intermittent claudication in his left calf . He was lacking of typical risk factors for arteriosclerosis and on first examination all pulses in both lower extremities were palpable and Doppler index on both legs was > 1. Only duplexsonography revealed a cystic formati on impressing the left popliteal artery in the hight of the rift in the pop liteal joint. (C) 2001 Elsevier Science Ireland Ltd. All rights reserved.