Spontaneous Resolution of Cystic Adventitial Disease of the
A 30-year-old male presented to hospital for rapid onset of severe claudication after walking 100 meters. History of smoking was his only cardiovascular risk factor. On examination, he had a cold right foot with no pulses palpable below the femoral artery on that side, with normal examination on the contralateral limb. Duplex scan (DS) of the lower limb arteries followed by contrast-enhanced computed tomography (CT) revealed a cystic lesion in the right popliteal artery with severe narrowing of the right popliteal artery lumen.

The patient was therefore diagnosed with the cystic adventitial disease and was scheduled to undergo resection with vein replacement surgery. The surgery was delayed due to scheduling issues. However, claudication suddenly improved at 2 months after the initial presentation. Examination showed normal distal pulses, and the duplex scan was repeated and showed normal flow in the right popliteal artery with no sign of cystic compression. Therefore, the surgery was canceled and decided on outpatient follow-up.

Contrast-enhanced CT was done at 6 months post-initial presentation and revealed that the CAD had disappeared with no signs of right popliteal artery stenosis. At the 12-month follow-up, the patient was still asymptomatic with no changes in the physical examination or on the DS done. The patient continues to be followed up as an outpatient.