Ann Ital Chir. 2020 Nov 2;9:S2239253X20033216.
The Persistent Sciatic Artery (PSA) is a rare congenital anomaly due to missed involution of embryo-fetal sciatic artery, which is the main blood supply to lower limb during embryonic development until superficial femoral artery (SFA) is formed. The PSA is frequently related to complications in adults like aneurysm and embolism. Here we present a case in which the discovery of a complete PSA resulted limb saving. In case of oncologic or trauma surgery, when no other options are available, the PSA can help in management of reconstructive surgery.
A case of PSA was discovered during management of a patient affected by a soft tissue sarcoma of the lower limb. Tumor resection needed the femoral neurovascular bundle demolition to ensure radical surgery and subsequent vascular reconstruction, which failed due to complications.
Despite failure reconstruction, a misdiagnosed type IIa PSA, replacing the role of the SFA, saved the lower limb from ischemia and subsequent amputation. Functional reconstruction was thus achieved with almost total recovery of lower limb function.
In oncological and trauma surgery we recommend investigate the whole lower limb vascularization, from the pelvis to the foot, suspecting the PSA existence. Indeed, although it is always preferable to reconstruct the SFA system despite a complete PSA is present, due to its frequent complications, the PSA can represent a limb saving option.
Computerized tomography angiography, Persistent sciatic artery, PSA, Superficial femoral artery, SFA fibromyxoid sarcoma.
永存坐骨动脉（PSA）是一种罕见的先天性异常，由于胚胎-胎儿坐骨动脉的未退化导致，其在胚胎发育过程中是下肢的主要血液供应，直到股浅动脉（SFA）形成。PSA 常与成人的动脉瘤和栓塞等并发症有关。在此，我们报告了一例因发现完全型 PSA 而得以保肢的病例。在肿瘤或创伤手术中，如果没有其他选择，PSA 可以帮助进行重建手术的管理。
在管理下肢软组织肉瘤患者的过程中发现了一例 PSA。肿瘤切除需要股神经血管束切除，以确保根治性手术和随后的血管重建，但由于并发症导致重建失败。
尽管重建失败，但误诊为 IIa 型 PSA 取代了 SFA 的作用，使下肢免于缺血和随后的截肢。因此，通过功能重建，下肢功能几乎完全恢复。
在肿瘤和创伤手术中，我们建议从骨盆到足部全面检查下肢的血管化情况，怀疑存在 PSA。事实上，尽管重建 SFA 系统总是更好，尽管存在完全型 PSA，但由于其频繁的并发症，PSA 可以作为保肢的选择。
计算机断层血管造影、永存坐骨动脉、PSA、股浅动脉、SFA 纤维黏液样肉瘤。
