Sutton Paul Anthony, Dyer James Edward, Guy Andrew
Surgery Department, Mid Cheshire NHS Trust, Crewe, Cheshire, UK.
BMJ Case Rep. 2011 Jun 17;2011:bcr0320114029. doi: 10.1136/bcr.03.2011.4029.
A 68-year-old male presented with an asymptomatic pulsatile swelling on the back of his left thigh. Angiography revealed this to be aneurysmal degeneration of a persistent sciatic artery (PSA), an embryological variant whereby the primitive vascular tree persists as the main blood supply to the lower limb. Initial treatment was with an inlay graft to exclude the aneurysm from the circulation. The patient was re-referred 12 years later with a pulsatile swelling distal to the old scar. Angiography showed a popliteal artery aneurysm separate to both the sciatic artery and the anastomosis. The second procedure fashioned an inlay graft from the original graft down to the distal popliteal artery. The patient remains under follow-up. Patients with a PSA are prone to aneurysmal degeneration, which may also occur in adjacent vessels. For this reason, the authors recommend these individuals are kept under lifelong follow-up.
一名68岁男性患者，左大腿后部出现无症状搏动性肿块。血管造影显示这是一条持续坐骨动脉（PSA）的动脉瘤样退变，PSA是一种胚胎学变异，即原始血管树持续作为下肢的主要血液供应。初始治疗采用镶嵌移植术，将动脉瘤排除在循环之外。12年后，患者因旧瘢痕远端出现搏动性肿块再次就诊。血管造影显示腘动脉瘤与坐骨动脉及吻合口均不相连。第二次手术从原移植血管向下至腘动脉远端制作了一个镶嵌移植血管。患者仍在随访中。PSA患者易发生动脉瘤样退变，相邻血管也可能出现这种情况。因此，作者建议对这些患者进行终身随访。
