Noninvasive vascular imaging in the diagnosis and treatment of adventitial cystic disease of the popliteal artery Arnold Miller, MBChB, Juha-P Salenius,

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Presentation transcript:

Noninvasive vascular imaging in the diagnosis and treatment of adventitial cystic disease of the popliteal artery Arnold Miller, MBChB, Juha-P Salenius, MD, Barry A. Sacks, MBChB, Sushil K. Gupta, MD, Gregory M. Shoukimas, MD Journal of Vascular Surgery Volume 26, Issue 4, Pages 715-720 (October 1997) DOI: 10.1016/S0741-5214(97)70076-4 Copyright © 1997 Society for Vascular Surgery and International Society for Cardiovascular Surgery, North American Chapter Terms and Conditions

Fig. 1 A, Sagittal ultrasound in the popliteal fossa demonstrates dilatation of popliteal artery, suggesting an aneurysm. True lumen (closed arrowheads) is surrounded by a sonolucent region (open arrowheads), suggesting intraluminal thrombus. B, Color flow examination shows pulsatile arterial flow only in the central patent lumen. Sagittal (C) and transverse (D) views through the same area confirm central lumen (arrow) and surrounding lucency. Journal of Vascular Surgery 1997 26, 715-720DOI: (10.1016/S0741-5214(97)70076-4) Copyright © 1997 Society for Vascular Surgery and International Society for Cardiovascular Surgery, North American Chapter Terms and Conditions

Fig. 2 Multiple axial CT scan sections obtained from cephalad to caudad in the popliteal fossa after administration of intravenous contrast. A low “water density” lesion is demonstrated (arrows) behind the contrast column compressing the luminal caliber of popliteal artery. Note the normal caliber of the artery above (top row) and below this region (bottom right). Journal of Vascular Surgery 1997 26, 715-720DOI: (10.1016/S0741-5214(97)70076-4) Copyright © 1997 Society for Vascular Surgery and International Society for Cardiovascular Surgery, North American Chapter Terms and Conditions

Fig. 3 A, T2 weighted axial MRI scans obtained through the popliteal fossa (similar to CT scans above) demonstrate two cysts, one anterior, the other posterior, compressing the popliteal artery. B, Sagittal T2 scan through the area demonstrates the adventitial cyst (very bright; arrows) surrounding and compressing the popliteal artery. MRA performed at the same time shows substantial narrowing of the popliteal artery. C, MRA shows significant stenosis of the popliteal artery (arrow) at the site of compression by the adventitial cysts. Journal of Vascular Surgery 1997 26, 715-720DOI: (10.1016/S0741-5214(97)70076-4) Copyright © 1997 Society for Vascular Surgery and International Society for Cardiovascular Surgery, North American Chapter Terms and Conditions

Fig. 3 A, T2 weighted axial MRI scans obtained through the popliteal fossa (similar to CT scans above) demonstrate two cysts, one anterior, the other posterior, compressing the popliteal artery. B, Sagittal T2 scan through the area demonstrates the adventitial cyst (very bright; arrows) surrounding and compressing the popliteal artery. MRA performed at the same time shows substantial narrowing of the popliteal artery. C, MRA shows significant stenosis of the popliteal artery (arrow) at the site of compression by the adventitial cysts. Journal of Vascular Surgery 1997 26, 715-720DOI: (10.1016/S0741-5214(97)70076-4) Copyright © 1997 Society for Vascular Surgery and International Society for Cardiovascular Surgery, North American Chapter Terms and Conditions

Fig. 3 A, T2 weighted axial MRI scans obtained through the popliteal fossa (similar to CT scans above) demonstrate two cysts, one anterior, the other posterior, compressing the popliteal artery. B, Sagittal T2 scan through the area demonstrates the adventitial cyst (very bright; arrows) surrounding and compressing the popliteal artery. MRA performed at the same time shows substantial narrowing of the popliteal artery. C, MRA shows significant stenosis of the popliteal artery (arrow) at the site of compression by the adventitial cysts. Journal of Vascular Surgery 1997 26, 715-720DOI: (10.1016/S0741-5214(97)70076-4) Copyright © 1997 Society for Vascular Surgery and International Society for Cardiovascular Surgery, North American Chapter Terms and Conditions

Fig. 4 A, Incision of adventitial cyst with release of tenacious yellowish material. B, Complete excision of cysts surrounding the artery demonstrates intact artery. Journal of Vascular Surgery 1997 26, 715-720DOI: (10.1016/S0741-5214(97)70076-4) Copyright © 1997 Society for Vascular Surgery and International Society for Cardiovascular Surgery, North American Chapter Terms and Conditions

Fig. 4 A, Incision of adventitial cyst with release of tenacious yellowish material. B, Complete excision of cysts surrounding the artery demonstrates intact artery. Journal of Vascular Surgery 1997 26, 715-720DOI: (10.1016/S0741-5214(97)70076-4) Copyright © 1997 Society for Vascular Surgery and International Society for Cardiovascular Surgery, North American Chapter Terms and Conditions