Debels H, De Gendt G
AZ Maria Middelares, Campus Sint-Jozef Gentbrugge, Belgium.
Acta Chir Belg. 2011 Jul-Aug;111(4):256-9.
In early embryologic development the sciatic artery provides the blood supply to the lower limb bud. When the femoral artery develops, the sciatic artery involutes. However, in rare cases, the sciatic artery persists. It can be visualised as a prolongation of the inferior gluteal artery (branch of the internal iliac artery) and it accompanies the sciatic nerve at the posterior side of the hip. We present the case of a 47-year old woman who consulted because of a numb right foot which presented colder and paler than the left foot. She also had a right painful calf, especially after exercise. Upon physical examination and doppler ultrasound there were no popliteal nor pedal artery pulses in the right leg. CT angiography showed bilateral persistent sciatic arteries with aneurysm formation and the presence of an embolus in the popliteal artery at the right side. Treatment involved thrombolysis of the popliteal occlusion, followed by intra-aneurysmatic stent placement and embolectomy of the popliteal artery and its distal branches. Postoperative clinical results were remarkably good and the patients symptoms dissolved.
A persistent sciatic artery is a rare vascular anomaly. It is more prone to vasculopathies such as aneurysm formation. In cases of acute ischemia, correct diagnosis and treatment of this anomaly can avoid serious medical consequences.
在胚胎发育早期，坐骨动脉为下肢芽提供血液供应。当股动脉发育时，坐骨动脉退化。然而，在罕见情况下，坐骨动脉会持续存在。它可表现为臀下动脉（髂内动脉分支）的延续，并在髋关节后侧伴行坐骨神经。我们报告一例47岁女性病例，该患者因右脚麻木就诊，右脚比左脚更凉、更苍白。她还伴有右小腿疼痛，尤其是运动后。体格检查和多普勒超声检查发现右腿腘动脉和足背动脉均无搏动。CT血管造影显示双侧坐骨动脉持续存在并形成动脉瘤，右侧腘动脉有栓子。治疗包括对腘动脉闭塞进行溶栓，随后在动脉瘤内放置支架，并对腘动脉及其远端分支进行栓子切除术。术后临床效果非常好，患者症状消失。
持续性坐骨动脉是一种罕见的血管异常。它更容易发生血管病变，如动脉瘤形成。在急性缺血病例中，对这种异常进行正确诊断和治疗可避免严重的医疗后果。
