Zystische Adventitiadegeneration

Background

This article describes the surgical resection procedures and percutaneous interventional therapy options for individual cases of rare cystic adventitial degeneration. The methods include percutaneous transluminal angioplasty (PTA) and ultrasound or computed tomography (CT) guided aspiration of the cystic contents. Due to the various therapy options preinterventional and preoperative assessment is important for a decision on the suitable therapy.

Method

A critical assessment of the therapy options, in particular ultrasound-guided cyst aspiration, will be presented exemplified by case examples and taking the etiology and pathomorphology into consideration. In addition a critical review of the literature between 1980 and 2012 will be presented.

Results

Sonography allows an accurate assessment for an adequate therapeutic approach due to the high site resolution. A review of the individual cases presented in the literature and own experience (using the methods in three selected cases) show that percutaneous, ultrasound-guided aspiration of cyst contents is primarily successful in the majority of cases and allows a long-term absence of recurrence in 60–70?% of cases. Surgical resection of recurrences is not affect by a prior cyst puncture.

Conclusion

The therapy of choice is surgical cyst enucleation or resection of the section of artery affected with a venous interpositional graft. In selected cases with solitary and small cysts, ultrasound-guided puncture with aspiration of the cyst contents can be used as a non-traumatic method. Sonography can be decisive for selection of an adequate therapy.