Adventitial cystic disease of the popliteal artery: treatment by cyst removal.

Controversy still exists concerning the optimal treatment for adventitial cystic disease of the popliteal artery: complete removal of the cyst without arterectomy or arteriectomy with venous replacement. In the two cases presented here, it was possible to completely excise the cyst and to preserve a solid arterial wall despite the magnitude of lesions documented on preoperative angiograms. Good functional and anatomic outcome has been maintained for 5 and 9 years, respectively. According to the available literature on pathologic data, complete cyst excision without arterial reconstruction is often feasible. Our results, as well as those published by others, suggest that short- and long-term outcome is better after complete cyst removal without than that with arterial reconstruction. As most patients are generally young adults, cystic excision should be preferred to venous bypass whenever feasible and whenever the remaining arterial wall seems to be healthy and solid.