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      Inconsistent Use of Terminology and Different Treatment Outcomes of Venous Adventitial Cystic Disease: A Proposal for Reporting Standards

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          Abstract

          Adventitial cystic disease (ACD) is a very rare condition characterized by the accumulation of a cyst filled with gelatinous substance in the adventitia of a vessel adjacent to the joint area. The cyst usually compresses the vessel lumen, causing claudication or leg swelling. The disease usually affects the popliteal artery. However, several cases of venous ACDs particularly in the common femoral or external iliac vein have been reported. The definition, diagnosis, and optimal treatment of ACD remain controversial because of its rarity and the inconsistent use of terminology. The heterogeneity of the reported cases is more prominent in venous ACD. Herein, the accurate terminology of cysts correlated to the joint (synovial cyst, ganglion cyst, and adventitial cyst) and the pathogenesis, anatomy, and optimal therapy of venous ACD are discussed in detail to establish reporting standards for future studies.

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          Most cited references32

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          The etiology and management of cystic adventitial disease.

          Cystic adventitial disease (CAD) is a rare condition that affects arteries and veins. The etiology remains controversial and several treatment methods have been described. By understanding the pathogenesis of CAD, we can improve the surgical treatment, reduce recurrence rates, and improve patient outcomes. The objective of this study was to perform a systematic review of the world's literature.
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            A case of myxomatous tumour arising in the adventitia of the left external iliac artery; case report.

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              Adventitial cystic disease: a unifying hypothesis.

              Six cases of adventitial cystic disease were studied, and the existing theories of the aetiology of adventitial cystic disease were reviewed to present evidence in support of a variation of the developmental hypothesis that might explain the sites of occurrence of this rare condition. Cases of adventitial cystic disease were collected by interrogation of the records of a group of vascular surgeons in the Johannesburg area. After reviewing the relevant literature, the sites of occurrence of 323 cases of adventitial cystic disease were documented, and the theories of the formation of adventitial cystic disease were reviewed. The embryological origin of those vessels in which adventitial cystic disease occurs was investigated. Clinical cases were collected in private practice vascular referral centers. The clinical features, treatment, and subsequent course of six cases of adventitial cystic disease (four related to the popliteal artery, one in the femoral artery, and one in the radial artery) are included. All cases of adventitial cystic disease reported have occurred in the nonaxial arteries, which form at a later stage than the axial vessels during limb differentiation and development. It is therefore postulated that during limb bud development cell rests derived from condensations of mesenchymal tissue destined to form the knee, hip, wrist, or ankle joints are incorporated into the nearby and adjacent nonaxial vessels during development of these vessels in the 15-22-week stage. These newly forming nonaxial vessels develop from vascular plexuses during the same stage of development, and in close proximity to the adjacent condensing joint structures. It is further postulated that these cell rests are then responsible for the formation of adventitial cystic disease later in life, when the mucoid material secreted results in a mass lesion within the arterial or venous wall. There is evidence supporting the hypothesis that adventitial cystic disease is a developmental condition occurring in the nonaxial blood vessels.
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                Author and article information

                Journal
                Vasc Specialist Int
                Vasc Specialist Int
                Vascular Specialist International
                The Korean Society for Vascular Surgery
                2288-7970
                2288-7989
                30 June 2020
                30 June 2020
                30 June 2020
                : 36
                : 2
                : 57-65
                Affiliations
                [1 ]Division of Vascular Surgery, Department of Surgery, Seoul National University College of Medicine, Seoul, Korea
                [2 ]Division of Vascular Surgery, Department of Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
                Author notes
                Corresponding author: Seung-Kee Min, Division of Vascular Surgery, Department of Surgery, Seoul National University Hospital, 101 Daehak-ro, Jongno-gu, Seoul 03080, Korea, Tel: 82-2-2072-0297, Fax: 82-2-766-3975, E-mail: skminmd@ 123456snuh.org , https://orcid.org/0000-0002-1433-2562
                Author information
                https://orcid.org/0000-0002-1433-2562
                https://orcid.org/0000-0002-3866-5214
                https://orcid.org/0000-0002-0688-0278
                https://orcid.org/0000-0001-8433-2202
                Article
                VSI-36-057
                10.5758/vsi.200029
                7333088
                32611837
                0f9ef3f9-6f9d-40df-a2c0-d712d5089893
                Copyright © 2020, The Korean Society for Vascular Surgery

                This is an open-access article distributed under the terms of the Creative Commons Attribution Non-Commercial License ( http://creativecommons.org/licenses/by-nc/4.0) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

                History
                : 10 May 2020
                : 21 May 2020
                Categories
                Review

                adventitial cystic disease,veins,synovial cyst,ganglion cysts,joints

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