Department of Vascular Surgery, The Second Affiliated Hospital, Hengyang Medical School, University of South China, Hengyang, China.
J Endovasc Ther. 2024 Dec;31(6):1252-1256. doi: 10.1177/15266028231163054. Epub 2023 Mar 30.
Persistent sciatic artery (PSA) is a rare congenital vascular malformation with an incidence of approximately 0.025% to 0.04%. Persistent sciatic artery has major complications, such as aneurysms, thrombosis, and occlusion. Complications may lead to a range of serious clinical problems, and a timely diagnosis of this vascular variant is crucial to avoid life-threatening complications.
A 65-year-old man was admitted to the hospital with pain and chills in the right lower extremity for 2 months, which gradually worsened. This was accompanied by numbness in the right foot for the last 10 days. Computed tomography angiography showed that the right inferior gluteal artery and right popliteal artery of the right internal iliac artery were connected, which is considered a congenital developmental variant. This was complicated by multiple thromboses of the right internal and external iliac arteries, and the right femoral artery. After admission to the hospital, the patient underwent endovascular staging surgery to relieve numbness and pain in the lower extremities.
Treatment strategies can be selected based on the anatomical characteristics of PSA and superficial femoral artery. Asymptomatic patients with PSA can be closely monitored. Surgery or individualized endovascular treatment plans should be considered for patients with aneurysm formation or vascular occlusion.
For the rare vascular variation of the PSA, clinicians must make a timely and accurate diagnosis. Ultrasound screening is essential, which requires experienced ultrasound doctors to be aware of vascular interpretation and develop personalized treatment plans for each patient. In this case, we adopt staged a minimally invasive intervention to solve the problem of lower limb ischemic pain for patients. This operation has the advantages of rapid recovery and less trauma, which has important reference significance for other clinicians.
持续性坐骨动脉（PSA）是一种罕见的先天性血管畸形，发病率约为 0.025%至 0.04%。PSA 存在主要并发症，如动脉瘤、血栓形成和闭塞。这些并发症可能导致一系列严重的临床问题，因此及时诊断这种血管变异对于避免危及生命的并发症至关重要。
一名 65 岁男性因右下肢疼痛和寒战入院 2 个月，症状逐渐加重。最后 10 天，右脚出现麻木。计算机断层血管造影显示右侧臀下动脉和右侧坐骨动脉相连，考虑为先天性发育变异。该患者还并发右侧髂内、外动脉和股动脉多发血栓形成。入院后，患者接受了血管腔内分期手术以缓解下肢麻木和疼痛。
可以根据 PSA 和股浅动脉的解剖特征选择治疗策略。无症状 PSA 患者可以密切监测。对于形成动脉瘤或血管闭塞的患者，应考虑手术或个体化的腔内治疗方案。
对于 PSA 这种罕见的血管变异，临床医生必须及时准确地诊断。超声筛查至关重要，这需要有经验的超声医生了解血管解读，并为每位患者制定个性化的治疗计划。在本例中，我们采用分期微创介入治疗方案解决了患者下肢缺血性疼痛的问题。该手术具有恢复快、创伤小的优点，对其他临床医生具有重要的参考意义。
