Martin K W, Hyde G L, McCready R A, Hull D A
J Vasc Surg. 1986 Oct;4(4):365-71.
Sciatic artery aneurysms (SAAs) develop in a persistent sciatic artery, which is a congenital anomalous continuation of the internal iliac artery and may be the major blood supply to the lower extremity. SAAs may appear clinically with rupture, thrombosis, distal embolization, or compression of the sciatic nerve. We have reviewed our three cases and the literature to delineate those factors that permit correct preoperative diagnosis and appropriate surgical intervention. Our three patients (aged 54 to 82 years) appeared with severe ischemia that resulted in above-knee amputations. The literature reveals 21 patients ranging in age from 35 to 84 years (58% were women). Twenty of those patients had operations, one of which resulted in death, and five in above-knee amputations. Unexplained sciatic or buttock pain, or a palpable "pulsating" buttock mass, suggests an SAA. The diagnosis is confirmed by angiography. The recommended treatment is femoropopliteal bypass grafting followed by ligature or percutaneous endovascular thrombosis of the aneurysm. Early diagnosis and correct surgical therapy are the keys to successful management of SAA.
坐骨动脉瘤（SAA）发生于持续存在的坐骨动脉，该动脉是髂内动脉的先天性异常延续，可能是下肢的主要血供来源。SAA临床症状可能表现为破裂、血栓形成、远端栓塞或坐骨神经受压。我们回顾了我们的3例病例及相关文献，以明确有助于术前正确诊断及采取适当手术干预的因素。我们的3例患者（年龄54至82岁）均表现为严重缺血，最终行膝上截肢术。文献报道的21例患者年龄在35至84岁之间（58%为女性）。其中20例患者接受了手术，1例死亡，5例行膝上截肢术。不明原因的坐骨或臀部疼痛，或可触及的“搏动性”臀部肿块提示SAA。血管造影可确诊。推荐的治疗方法是股腘动脉旁路移植术，随后结扎或经皮血管内栓塞动脉瘤。早期诊断和正确的手术治疗是成功处理SAA的关键。
