Shutze W P, Garrett W V, Smith B L
Department of Surgery, Baylor University Medical Center, Dallas, Tex.
Ann Vasc Surg. 1993 May;7(3):303-10. doi: 10.1007/BF02000260.
One of the rarer anatomic variants is persistent sciatic artery. Only 93 cases have been reported since the first description of this anomaly. The earlier reports were mainly pathologic descriptions, whereas the more recent have been clinically oriented. There is a slight male predominance, and the average age of presentation is 49 years old (range 6 months to 85 years). The majority of patients have symptoms of a mass, ischemia, or gluteal pain. There is no preference for the right or left side, and one in four patients has both legs affected. In this anomaly the sciatic vessel acts as the principal blood supply to the lower limb. One half of all patients develop aneurysms that are characteristically located caudal to the sciatic notch as opposed to gluteal aneurysms that are cephalad to this landmark. Various methods (some now obsolete) have been tried to treat these aneurysms, but the best results were obtained through aneurysm ablation and vascular reconstruction. Arterial bypasses succeeded when used for ischemic complications of persistent sciatic artery. Optimal management of this condition requires prompt recognition, an understanding of the developmental anatomy, exclusion and bypass of aneurysms, appropriate vascular intervention for ischemic sequelae, and close observation of asymptomatic individuals.
较罕见的解剖变异之一是坐骨动脉持续存在。自首次描述这种异常以来，仅报告了93例病例。早期报告主要是病理学描述，而最近的报告则以临床为导向。男性略占优势，出现症状的平均年龄为49岁（范围为6个月至85岁）。大多数患者有肿块、缺血或臀痛症状。左右侧无明显偏好，四分之一的患者双腿受累。在这种异常情况下，坐骨血管成为下肢的主要血液供应。所有患者中有一半会形成动脉瘤，其特征性位置在坐骨切迹下方，而臀动脉瘤则位于该标志上方。人们尝试了各种方法（有些现已过时）来治疗这些动脉瘤，但通过动脉瘤切除和血管重建获得了最佳效果。当用于坐骨动脉持续存在的缺血性并发症时，动脉搭桥术取得了成功。对这种情况的最佳管理需要迅速识别、了解发育解剖结构、排除和绕过动脉瘤、对缺血后遗症进行适当的血管干预，以及密切观察无症状个体。
