PMC5688377_01
Computed tomography revealed simple cystic lesion at the popliteal artery and stenosis of the artery in this lesion. White arrow: cystic lesion of popliteal artery. Blue arrow: venous aneurysm (it was not diagnosed preoperatively).
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Computed tomography revealed simple cystic lesion at the popliteal artery and stenosis of the artery in this lesion (Figure 1). In fact, the venous aneurysm was revealed by preoperative computed tomography and we confirmed it during the operation (Figure 1).
Magnetic resonance imaging (T2-weighted images) revealed cystic lesion encompassing the right popliteal artery circumferentially. Red arrow: cystic adventitial disease of popliteal artery. Blue arrow: venous aneurysm of popliteal vein (it was not diagnosed preoperatively).
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This cystic lesion exhibited high signal intensity of T2-weighted images (Figure 2).
The circumferential cystic enlargement of popliteal artery.
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The circumferential cystic enlargement of popliteal artery was revealed (Figure 3).
(a) Intraoperative echo findings revealed cystic adventitial lesion compressed internal lumen of popliteal artery (white arrow). (b) Intraoperative echo findings after resection of adventitial cyst revealed improved arterial compression and ligated venous aneurysm without blood flow (black arrow).
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It was confirmed as a cystic disease by intraoperative echo (Figure 4(a)). Arterial pulsation improved immediately (Figure 4(b)). During the procedure, a saccular venous aneurysm of popliteal vein was revealed, just lateral to the popliteal artery (Figure 4(a)), and it was ligated at the orifice (Figure 6).
Clear viscous liquid flowed out after cutting the adventitial layer (arrow). (b) After resection of cystic adventitial lesion (arrow).
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Cutting the adventitial layer was done, when clear viscous liquid element flowed out (Figure 5(a)). Complete resection of cystic adventitial layer was made (Figure 5(b)).
The arrow shows the neck of venous aneurysm. Venous aneurysm of popliteal vein was ligated.
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During the procedure, a saccular venous aneurysm of popliteal vein was revealed, just lateral to the popliteal artery (Figure 4(a)), and it was ligated at the orifice (Figure 6).
Postoperative MRI revealed 5 square mm of high intensity adventitial area (arrow) that was suspected as remaining cystic lesion.
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Postoperative MRI revealed 5 square mm of high intensity adventitial area that is suspected as the remanence of the cystic lesion (Figure 7).