Yamaguchi M, Mii S, Kai T, Sakata H, Mori A
Department of Surgery, Nippon Steel Corporation Yawata Works Hospital, Kitakyushu-city, Japan.
Surg Today. 1997;27(9):863-7. doi: 10.1007/BF02385280.
Two elderly women complaining of intermittent claudication complicated with persistent sciatic artery are herein reported. A direct femoral arteriogram showed hypoplasty of the superficial femoral artery and an unnatural anatomical relationship between the distal superficial femoral artery and the proximal popliteal artery, thus suggesting the presence of persistent sciatic artery. The diagnosis of persistent sciatic artery was finally made based on the aortography findings including the iliac arterial system and computed tomography (CT) scan. Magnetic resonance imaging (MRI) was helpful to demonstrate the entire image of this anomaly in cases with non-thrombolized sciatic artery. These diagnostic methods were useful in designing the optimal surgical strategy. The first case with a gluteal pulsating mass underwent exclusion of the persistent sciatic artery including the aneurysm through a retroperitoneal approach with a combination of femorotibial bypass, while the second case with thrombosed persistent sciatic artery only underwent femoropopliteal bypass. To recognize such a rare lesion, awareness of the differential diagnosis is important, and to provide appropriate treatment, an accurate whole image including adequate angiography, a CT scan, and magnetic resonance imaging is necessary.
本文报告了两名老年女性，她们主诉间歇性跛行并伴有持续性坐骨动脉。直接股动脉造影显示股浅动脉发育不全，股浅动脉远端与腘动脉近端之间存在异常的解剖关系，提示存在持续性坐骨动脉。最终根据包括髂动脉系统的主动脉造影结果和计算机断层扫描（CT）做出了持续性坐骨动脉的诊断。磁共振成像（MRI）有助于在坐骨动脉未发生血栓形成的病例中显示这种异常的全貌。这些诊断方法有助于制定最佳手术策略。第一例有臀部搏动性肿块的患者通过腹膜后入路，结合股胫旁路手术，对包括动脉瘤在内的持续性坐骨动脉进行了旷置，而第二例坐骨动脉血栓形成的患者仅接受了股腘旁路手术。要认识到这种罕见病变，了解鉴别诊断很重要，为提供适当治疗，需要包括充分血管造影、CT扫描和磁共振成像的准确全貌。
