Ikezawa T, Naiki K, Moriura S, Ikeda S, Hirai M
Department of Surgery Aichi Prefectural Owari Hospital, Ichinomiya, Japan.
J Vasc Surg. 1994 Jul;20(1):96-103. doi: 10.1016/0741-5214(94)90180-5.
A case of bilateral persistent sciatic artery (PSA) aneurysms with thromboembolic complications is presented along with a review of the 167 cases of PSA reported in the world literature. Its embryology, anatomy, clinical features, diagnosis, and treatment are reviewed and provide the following findings: The incidence of PSA is estimated to be from 0.025% to 0.04%, based on angiographic studies. Ages range from 6 months to 89 years, with a mean of 54 years. There is no gender predilection. A PSA was present on the right side in 32%, on the left side in 29%, bilaterally in 22%, and on either side in 18%. The "complete" type of PSA was 69%. Aneurysmal change was present in 46% of all PSAs. Overall, 59% had symptoms, including ischemia in 31% (acute in 14% and chronic in 17%), a gluteal mass in 26% (painful in 10%, painless in 6%, and pulsatile in 13%), gluteal pain in 2%, and ischialgia in 5%. Exclusion of the aneurysm or PSA by surgical or interventional techniques, with a femorodistal bypass as required for the resultant ischemia is currently the treatment of choice.
本文报告了一例双侧持续性坐骨动脉（PSA）动脉瘤伴血栓栓塞并发症的病例，并对世界文献中报道的167例PSA病例进行了回顾。对其胚胎学、解剖学、临床特征、诊断和治疗进行了综述，结果如下：根据血管造影研究，PSA的发病率估计为0.025%至0.04%。年龄范围为6个月至89岁，平均54岁。无性别倾向。右侧PSA占32%，左侧占29%，双侧占22%，单侧占18%。“完全”型PSA占69%。所有PSA中有46%发生动脉瘤样改变。总体而言，59%有症状，包括31%有缺血症状（14%为急性缺血，17%为慢性缺血），26%有臀肌肿块（10%有疼痛，6%无疼痛，13%有搏动），2%有臀痛，5%有坐骨神经痛。目前的治疗选择是通过手术或介入技术排除动脉瘤或PSA，并根据由此产生的缺血情况进行股-远端旁路移植术。
