Noblet D, Gasmi T, Mikati A, Watel A, Warembourg H, Soots G
Service de Chirurgie Cardiovasculaire A, Hôpital Cardiologique, Lille, France.
Ann Vasc Surg. 1988 Oct;2(4):390-6. doi: 10.1016/S0890-5096(06)60823-6.
We report the case of a 64-year-old woman with an aneurysm of a left persistent sciatic artery presenting with arterial insufficiency from distal embolization. Treatment was exclusion of the aneurysm and femoropopliteal bypass after distal embolectomy with a Fogarty balloon catheter. We reviewed 71 cases in the literature to define characteristics of this anomaly which has many synonyms: including persistent sciatic artery, persistent axial artery, ischiopopliteal trunk. The persistence of the sciatic portion of the embryonic dorsal axial artery and failure of development of anastomoses with the ventral femoral network results in the anomaly. The persistent sciatic artery was "complete" in 75% of cases. In this configuration, it arises from the internal iliac artery, leaves the pelvic cavity through the lower part of the greater sciatic foramen caudad to the pyriformis muscle, reaches the posterior compartment of the thigh and continues as the popliteal artery. In 35% of cases, the artery is aneurysmal with a pulsatile mass in the buttock or a complication of the aneurysm. Arteriography required for diagnosis of the mass leads to discovery of the anomaly in many cases. The treatment of choice is exclusion followed by femoropopliteal vein bypass.
我们报告了一例64岁女性，其左坐骨动脉持续性动脉瘤因远端栓塞出现动脉供血不足。治疗方法是在使用Fogarty球囊导管进行远端栓子切除术之后，对动脉瘤进行旷置并实施股腘动脉旁路移植术。我们回顾了文献中的71例病例，以明确这种有许多同义词的异常情况的特征，这些同义词包括持续性坐骨动脉、持续性轴动脉、坐骨腘干。胚胎背侧轴动脉坐骨部分的持续存在以及与股前网络吻合支发育失败导致了这种异常。在75%的病例中，持续性坐骨动脉是“完整的”。在这种情况下，它起自髂内动脉，经梨状肌下方的坐骨大孔下部离开盆腔，到达大腿后间隙并延续为腘动脉。在35%的病例中，该动脉呈动脉瘤样，在臀部有搏动性肿块或出现动脉瘤并发症。诊断该肿块所需的动脉造影在许多情况下会发现这种异常。首选的治疗方法是旷置，然后进行股腘静脉旁路移植术。
