Jung Ah Young, Lee Whal, Chung Jin Wook, Song Soon-Young, Kim Sang Joon, Ha Jongwon, Jae Hwan Jun, Park Jae Hyung
Department of Diagnostic Radiology, Seoul National University College of Medicine, Republic of Korea.
J Vasc Surg. 2005 Oct;42(4):678-83. doi: 10.1016/j.jvs.2005.06.001.
To define the role of computed tomographic (CT) angiography in the evaluation of persistent sciatic artery and to identify its potential advantages as a diagnostic modality.
Between July 2002 and August 2004, 307 consecutive patients underwent CT angiography for suspected lower-extremity arterial insufficiency. All CT angiograms were retrospectively reviewed to determine the presence and laterality of persistent sciatic artery and its associated vascular abnormalities, such as aneurysm, thrombus, distal thromboembolism, and atherosclerotic change. The relationship of persistent sciatic artery with adjacent structures, such as sciatic nerve, muscle, accompanying vein, and femoral artery, as well as the presence of other anomalies, was analyzed. Clinical data regarding the presenting symptoms and hospital course were obtained from patient charts.
Six persistent sciatic arteries, with or without occlusion, were identified in five female patients (age range, 54 to 80 years). CT angiography revealed unilateral persistent sciatic artery in four patients (left, 3; right, 1) and bilateral persistent sciatic artery in one patient. Aneurysm was present in two (mean size, 26 mm x 20 mm), thrombosis in three, and distal thromboembolism in all six persistent sciatic arteries. All persistent sciatic arteries coursed along the sciatic nerve and continued as popliteal artery. Characteristically, in all these instances, the superficial femoral arteries were hypoplastic and tapered smoothly. Anomalous popliteal venous drainage was noted in all ipsilateral limbs with persistent sciatic artery and even in contralateral limbs with normal superficial femoral artery in all but one.
CT angiography enables the detection of persistent sciatic artery even in the presence of complete occlusion and is useful in the comprehensive evaluation of various complications and associated venous anomalies. It can potentially be used as the sole imaging modality for persistent sciatic artery.
明确计算机断层扫描（CT）血管造影在评估持续性坐骨动脉中的作用，并确定其作为一种诊断方式的潜在优势。
在2002年7月至2004年8月期间，307例连续患者因疑似下肢动脉供血不足接受了CT血管造影检查。所有CT血管造影图像均进行回顾性分析，以确定持续性坐骨动脉的存在及侧别，以及其相关血管异常，如动脉瘤、血栓、远端血栓栓塞和动脉粥样硬化改变。分析持续性坐骨动脉与相邻结构，如坐骨神经、肌肉、伴行静脉和股动脉的关系，以及其他异常情况的存在。从患者病历中获取有关当前症状和住院过程的临床资料。
在5例女性患者（年龄范围54至80岁）中发现6条持续性坐骨动脉，有或无闭塞。CT血管造影显示4例患者为单侧持续性坐骨动脉（左侧3例；右侧1例），1例患者为双侧持续性坐骨动脉。6条持续性坐骨动脉中有2条存在动脉瘤（平均大小为26 mm×20 mm），3条有血栓形成，所有6条均有远端血栓栓塞。所有持续性坐骨动脉均沿坐骨神经走行并延续为腘动脉。其特征是，在所有这些病例中，股浅动脉发育不全并呈平滑变细。在所有伴有持续性坐骨动脉的同侧肢体中均发现腘静脉引流异常，除1例患者外，在股浅动脉正常的对侧肢体中也发现了腘静脉引流异常。
CT血管造影即使在完全闭塞的情况下也能检测到持续性坐骨动脉，有助于对各种并发症及相关静脉异常进行综合评估。它有可能作为评估持续性坐骨动脉的唯一影像学检查方法。
