Clinical outcome after surgical and endovascular treatment of symptomatic persistent sciatic artery with review of the literature and reporting of three cases

Vascular. 2016 Oct;24(5):469-80. doi: 10.1177/1708538115611791. Epub 2015 Oct 12.

Abstract

A persistent sciatic artery is a very rare vascular anomaly with an estimated incidence of 0.025-0.06% and with less than 200 described cases in the literature. During early embryonic development, the sciatic artery delivers the major blood supply to the lower limb and usually disappears when the superficial femoral artery has developed properly. The usual form of presentation in adults is the aneurysmal degeneration of the sciatic artery or less frequently with another complication (thrombosis, embolism, neuralgia). We describe three cases of a complete sciatic artery (two cases are bilateral and one is unilateral) associated with lower limb ischemia caused by embolism from the aneurysmal degeneration of the sciatic artery at the buttock level in two cases and atherosclerotic degeneration of the lower limb arteries in the third case. We also describe two combined therapy methods consisted of limb revascularization with vein-graft bypass and endovascular embolization of the aneurysm with vascular plug in the first case, in the second case combination of localized thrombolysis therapy followed by a bypass and an ilio-pedal vein bypass in the third one. And we discuss later the reported clinical outcome after surgical and endovascular treatment of this anomaly in the literature.

Keywords: Persistent sciatic artery; aneurysm; endovascular therapy.

Publication types

  • Case Reports
  • Review

MeSH terms

  • Aged
  • Aneurysm / complications
  • Aneurysm / diagnostic imaging
  • Aneurysm / surgery
  • Aneurysm / therapy*
  • Angiography, Digital Subtraction
  • Ankle Brachial Index
  • Arteries / abnormalities
  • Arteries / diagnostic imaging
  • Arteries / surgery*
  • Atherosclerosis / complications
  • Atherosclerosis / diagnostic imaging
  • Atherosclerosis / surgery
  • Atherosclerosis / therapy*
  • Computed Tomography Angiography
  • Embolism / diagnostic imaging
  • Embolism / etiology
  • Embolism / surgery
  • Embolism / therapy*
  • Embolization, Therapeutic*
  • Endovascular Procedures*
  • Female
  • Humans
  • Ischemia / diagnostic imaging
  • Ischemia / etiology
  • Ischemia / surgery
  • Ischemia / therapy*
  • Lower Extremity / blood supply*
  • Male
  • Middle Aged
  • Thrombolytic Therapy*
  • Treatment Outcome
  • Vascular Malformations / complications*
  • Vascular Malformations / diagnostic imaging
  • Veins / transplantation*