Jornal Vascular Brasileiro
https://www.jvascbras.org/article/doi/10.1590/S1677-54492012000200012
Jornal Vascular Brasileiro
Therapeutic Challenge

Isquemia crítica em membro inferior em paciente jovem com doença cística de artéria poplítea

Critical limb ischemia in a young patient with cystic disease of the popliteal artery

Michel Nasser; Luca Giovanni Antonio Pivetta; José Luis Teixeira Filho; Evelin Schueteze Rocha; Ana Eliza Botta

http://dx.doi.org/10.1590/S1677-54492012000200012 J Vasc Bras, vol.11, n2, p.144-149, 2012
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Resumo

Degeneração cística da artéria poplítea é uma doença vascular rara, de etiologia desconhecida, na qual um cisto com conteúdo mucinoide compromete a artéria e desenvolve estenose ou oclusão do vaso. Apresentamos um caso de um paciente do sexo masculino, 45 anos, admitido na emergência hospitalar, que apresentava quadro de isquemia aguda no membro inferior esquerdo. Submetido à EcoDoppler, angiorressonância magnética e angiografia pré-operatória. Realizada arterectomia com enxerto fêmoro-poplíteo infrainguinal de safena invertida. O exame patológico foi consistente com o diagnóstico de doença cística da artéria poplítea. O paciente encontra-se em acompanhamento ambulatorial e foi acometido pela doença cística no membro contralateral. Os autores descreveram os melhores métodos de diagnóstico e tratamento para a doença, discutindo se o procedimento de urgência foi o mais adequado e se haveria opções terapêuticas alternativas para o caso, além de qual seria a melhor conduta a ser realizada no membro contralateral também acometido pela doença.

Palavras-chave

claudicação intermitente, cisto, artéria poplítea

Abstract

Cystic adventitial disease of the popliteal artery is a rare vascular disease of unknown etiology in which a mucin-containing cyst may compromise the artery and, because of the compression, develops stenosis or occlusion of affected artery. We report the case of a 45-year-old male with cystic adventitial disease of the left popliteal artery, after admission for an acute limb ischemia in his left leg, diagnosed non-invasively with EcoDoppler vascular dual scan, magnetic resonance angiography, angiography. Performed complete removal of the cyst with arteriectomy and venous replacement. The pathologic result ware consistent with the diagnostic of cystic adventitial disease. The patient is in ambulatory follow up and was affected by cystic disease in the contralateral limb. The authors described the best methods of diagnosis and treatment for cystic adventitial disease, discussing if the urgency procedure was the most appropriate and whether there was an alternative treatment for the case. Finally, questioning what would be the best procedure to be performed in the other limb.

Keywords

intermittent claudication, cyst, popliteal artery

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