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Title: Percutaneous Image-Guided Aspiration and Sclerosis of Adventitial Cystic Disease of the Femoral Vein

Abstract

Adventitial cystic disease (ACD), also known as cystic mucoid or myxomatous degeneration, is a rare vascular disease mainly seen in arteries. Seventeen cases have been reported in the world literature. We report the first known case of ACD successfully treated with percutaneous image-guided ethanol sclerosis. Computed tomography showed a cystic mass adherent to the wall of the common femoral vein. An ultrasound examination revealed a deep venous thrombosis of the leg, secondary to extrinsic compression of the common femoral vein. Three years prior to our procedure, the cyst was aspirated, which partially relieved the patient's symptoms. Over the following 3 years the patient's symptoms worsened and a 10-cm discrepancy in thigh size developed, in addition to the deep venous thrombosis associated with lower-extremity edema. Using ultrasound guidance and fluoroscopic control, the cyst was drained and then sclerosed with absolute ethanol. The patient's symptoms and leg swelling resolved completely within several weeks. Follow-up physical examination and duplex ultrasound 6 months following sclerosis demonstrated resolution of the symptoms and elimination of the extrinsic compression effect of the ACD on the common femoral vein.

Authors:
 [1]; ;  [2];  [1]
  1. University of Vermont College of Medicine, Fletcher Allen Health Care, Section of Interventional Radiology, Department of Radiology (United States)
  2. Fletcher Allen Health Care, Section of Vascular Surgery, Department of Surgery (United States)
Publication Date:
OSTI Identifier:
21428493
Resource Type:
Journal Article
Journal Name:
Cardiovascular and Interventional Radiology
Additional Journal Information:
Journal Volume: 32; Journal Issue: 4; Other Information: DOI: 10.1007/s00270-009-9581-z; Copyright (c) 2009 Springer Science+Business Media, LLC and the Cardiovascular and Interventional Radiological Society of Europe (CIRSE); Journal ID: ISSN 0174-1551
Country of Publication:
United States
Language:
English
Subject:
62 RADIOLOGY AND NUCLEAR MEDICINE; ARTERIES; COMPUTERIZED TOMOGRAPHY; CYSTS; IMAGES; LEGS; SWELLING; THROMBOSIS; VEINS; BLOOD VESSELS; BODY; CARDIOVASCULAR DISEASES; CARDIOVASCULAR SYSTEM; DEFORMATION; DIAGNOSTIC TECHNIQUES; DISEASES; LIMBS; ORGANS; PATHOLOGICAL CHANGES; TOMOGRAPHY; VASCULAR DISEASES

Citation Formats

Johnson, Jason M., Kiankhooy, Armin, Bertges, Daniel J., and Morris, Christopher S., E-mail: Christopher.Morris@vtmednet.or. Percutaneous Image-Guided Aspiration and Sclerosis of Adventitial Cystic Disease of the Femoral Vein. United States: N. p., 2009. Web. doi:10.1007/S00270-009-9581-Z.
Johnson, Jason M., Kiankhooy, Armin, Bertges, Daniel J., & Morris, Christopher S., E-mail: Christopher.Morris@vtmednet.or. Percutaneous Image-Guided Aspiration and Sclerosis of Adventitial Cystic Disease of the Femoral Vein. United States. doi:10.1007/S00270-009-9581-Z.
Johnson, Jason M., Kiankhooy, Armin, Bertges, Daniel J., and Morris, Christopher S., E-mail: Christopher.Morris@vtmednet.or. Wed . "Percutaneous Image-Guided Aspiration and Sclerosis of Adventitial Cystic Disease of the Femoral Vein". United States. doi:10.1007/S00270-009-9581-Z.
@article{osti_21428493,
title = {Percutaneous Image-Guided Aspiration and Sclerosis of Adventitial Cystic Disease of the Femoral Vein},
author = {Johnson, Jason M. and Kiankhooy, Armin and Bertges, Daniel J. and Morris, Christopher S., E-mail: Christopher.Morris@vtmednet.or},
abstractNote = {Adventitial cystic disease (ACD), also known as cystic mucoid or myxomatous degeneration, is a rare vascular disease mainly seen in arteries. Seventeen cases have been reported in the world literature. We report the first known case of ACD successfully treated with percutaneous image-guided ethanol sclerosis. Computed tomography showed a cystic mass adherent to the wall of the common femoral vein. An ultrasound examination revealed a deep venous thrombosis of the leg, secondary to extrinsic compression of the common femoral vein. Three years prior to our procedure, the cyst was aspirated, which partially relieved the patient's symptoms. Over the following 3 years the patient's symptoms worsened and a 10-cm discrepancy in thigh size developed, in addition to the deep venous thrombosis associated with lower-extremity edema. Using ultrasound guidance and fluoroscopic control, the cyst was drained and then sclerosed with absolute ethanol. The patient's symptoms and leg swelling resolved completely within several weeks. Follow-up physical examination and duplex ultrasound 6 months following sclerosis demonstrated resolution of the symptoms and elimination of the extrinsic compression effect of the ACD on the common femoral vein.},
doi = {10.1007/S00270-009-9581-Z},
journal = {Cardiovascular and Interventional Radiology},
issn = {0174-1551},
number = 4,
volume = 32,
place = {United States},
year = {2009},
month = {7}
}