J Korean Soc Radiol.  2015 Dec;73(6):384-388. 10.3348/jksr.2015.73.6.384.

Percutaneous Ethanol Sclerotherapy for Recurrent Adventitial Cystic Disease of External Iliac Vein after Surgical Treatment: A Case Report

• Ann JH
• Kim JH
• Byun SS
• Kang JM
• Kim HS
• Choi HY

• KMID: 2130943
• DOI: http://doi.org/10.3348/jksr.2015.73.6.384

Abstract

Adventitial cystic disease (ACD) is a rare, but well-characterized vascular disease. It is most commonly seen in the popliteal artery, but it has also been reported in the venous system. The most commonly involved segment has been the common femoral vein; the disease resulted in luminal compromise and extremity swelling. We report here on a case of percutaneous aspiration and ethanol sclerotherapy for recurrent ACD after surgery of the external iliac vein in a 70-year-old man who presented with a painless swelling of his left leg.

MeSH Terms

Aged
Ethanol*
Extremities
Femoral Vein
Humans
Iliac Vein*
Leg
Phenobarbital
Popliteal Artery
Sclerotherapy*
Vascular Diseases
Ethanol
Phenobarbital

Figure

• 

  Fig. 1 Axial CT angiography image at inguinal area. Newly developed state of cystic lesion (arrow) outside the patch graft in left external iliac vein. Patch graft is compressed and the external iliac vein lumen shows near total occlusion.

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  Fig. 2 Duplex ultrasound image of left external iliac vein. Anechoic cystic lesion (arrow) outside the patch graft in left external iliac vein. Patch graft is compressed and the left external iliac vein lumen shows near total occlusion.

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  Fig. 3 Cystogram by ultrasonography guided puncture of the cystic lesion at the left external iliac vein. Ethanol sclerotherapy is performed at recurrent adventitial cystic disease (arrow).

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  Fig. 4 Venogram after puncture of left popliteal vein. Contrast filling defect is found at left proximal portion of femoral vein (arrow) with collateral vessels. Also, contrast filling defect at left common femoral vein (double arrows). These findings are compatible with deep vein thrombosis.

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  Fig. 5 Balloon angioplasty using 10 mm-4 cm balloon catheter (BLUE MAX, Boston Scientific) is performed at occluded segment.

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  Fig. 6 Final angiogram shows focal irregular contrast filling defects (arrows) in left common femoral vein, but good blood flow and disappeared collateral vessels.

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