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Case of the Month

December 2013

Patient Data: Female patient 50 years old

Clinical Info: Patient was referred to exclude a deep venous thrombosis. She had pain in the calf that progressed during walking. She could not walk without pain for more than 100 meters

Longitudinal image of the popliteal artery showing a severe stenosis with a very narrow and irregular lumen

Another longitudinal image of the same popliteal artery with severe stenosis. The more superficial lying popliteal vein is patent

Transverse image of the same artery and vein

Detail image of the popliteal artery. The stenosis is not caused by atherosclerotic changes

transverse image of the popliteal artery showing cystic changes in the wall of the artery

52552-poplitea2.swf MRA showing absent flow in the politeal artery

52553-poplitea.swf Detail of the popliteal area

52554-poplitea3.swf MRI of the knee showing cystic lesions

52555-poplitea4.swf MRI

52556-poplitea5.swf MRI

52557-poplitea6.swf MRI

Longitudinal image of the common femoral artery in another older male patient also showing cystic changes in the outer layer of the arterial wall. The intima layer is completely normal. The cystic changes cause minimal impression of the lumen

Longitudinal image of the common femoral artery showing the cystic changes

Transverse image of the common femoral artery showing the cystic changes

Longitudinal detail image of the cystic changes

The deep venous system in both patients was completely normal.
There was a significant stenosis in the popliteal artery of the first patient that was caused by cystic adventitial disease. The second older patient also had cystic adventitial changes but without a significant stenosis

Copyright © Dr. T.S.A. Geertsma, Ziekenhuis Gelderse Vallei, Ede, The Netherlands. All rights reserved.

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