Ukita Kohei, Shutta Ryu, Nishino Masami, Tanouchi Jun
Cardiology, Osaka Rosai Hospital, Sakai, Osaka, Japan.
Cardiology, Osaka Rosai Hospital, Sakai, Osaka, Japan
BMJ Case Rep. 2021 Apr 20;14(4):e240637. doi: 10.1136/bcr-2020-240637.
Persistent sciatic artery (PSA) is a rare vascular anomaly that can cause acute limb ischaemia (ALI) due to peripheral thromboembolism following aneurysm formation, and surgical repair or exclusion with or without femoropopliteal bypass is the standard treatment for these symptomatic cases of PSA. Here, we report a case of a 70-year-old man with right PSA aneurysm who suffered from recurrent ALI despite the history of right femoropopliteal bypass at the age of 58 for occlusion of right PSA and graft (femoropopliteal bypass graft)-to-tibial bypass at the age of 68 for occlusion of right posterior tibial artery. We performed a catheter angiographic examination using an intravascular ultrasound and performed an endovascular therapy (EVT) for the purpose of jailing the internal iliac artery. This is a rare case of PSA aneurysm presenting with recurrent ALI after femoropopliteal bypass successfully treated with EVT.
持续性坐骨动脉（PSA）是一种罕见的血管异常，可因动脉瘤形成后外周血栓栓塞导致急性肢体缺血（ALI），对于这些有症状的PSA病例，手术修复或采用或不采用股腘动脉旁路移植术的封堵术是标准治疗方法。在此，我们报告一例70岁男性，患有右侧PSA动脉瘤，尽管其在58岁时因右侧PSA闭塞接受了右侧股腘动脉旁路移植术，68岁时因右侧胫后动脉闭塞接受了移植血管（股腘动脉旁路移植血管）至胫动脉旁路移植术，但仍反复发生ALI。我们使用血管内超声进行了导管血管造影检查，并为栓塞髂内动脉进行了血管内治疗（EVT）。这是一例罕见的PSA动脉瘤病例，在股腘动脉旁路移植术后出现反复ALI，并通过EVT成功治疗。
