Adventitial Cystic Disease of the Popliteal Artery
A 49-year-old female presented with a 3-week history of left calf intermittent claudication at 150 m, which had occurred suddenly and without preliminary herald signs. The patient was a nonsmoker and had no risk factors, such as hypertension, diabetes or hyperlipidaemia. She was engaged in regular sporting activity, playing tennis all year round and skiing in the winter. She thought at first that it might be a strained muscle and would subside spontaneously. This did not happen and she sought medical advice.
At clinical examination, the popliteal and pedal pulses of the left leg were barely palpable and were absent after exercise. Angiological examination of the right leg was normal. The ankle systolic pressure at the right side was 128 mmHg with a slight rise to 132 mmHg after exercise. On the left side, ankle systolic pressure at rest was 88 mmHg with a post-exercise reduction to 58 mmHg. On duplex sonography, a 5-cm long polycystic swelling surrounding the left popliteal...
Special thanks go to Professor Jon Largiadèr, who offered the documentation of the two patients operated on by him at the University Hospital of Zurich.