Bilateral persistent complete sciatic artery

Abstract

A case with persistent sciatic artery (PSA) was found in a cadaver of a 65-year-old female during a medical gross anatomy course. The artery was bilateral and complete and provided the major blood supply to both lower extremities. The vessel arose from the internal iliac artery that was extremely large bilaterally. The sciatic artery passed out of the pelvis through the infrapiriform foramen and descended posterior to the sciatic nerve through the gluteal region. The sciatic nerve was considerably flattened out under the artery. Large articular branches arose from the part of the artery at the buttock just below the piriform muscle. The artery descended along the back of the thigh and was crossed obliquely posteriorly by the long head of the biceps femoris muscle. The sciatic artery continued as the popliteal artery located very superficially in the popliteal fossa. A companion vein, i.e., the sciatic vein, accompanied each artery. The right sciatic vein entered the pelvis posteriorly through the infrapiriform foramen, whereas the left perforated the quadriceps muscle from behind and joined the femoral vein anteriorly. There was a gracile superficial femoral artery bilaterally. The deep femoral arteries of both lower limbs were hypoplastic with slender circumflex branches. There were no macroscopic connections between the sciatic and the deep or superficial femoral arteries on either side. This anomaly should be kept in mind in the evaluation of patients with sciatic or buttock pain or palpable "pulsating" buttock mass. Persistent sciatic artery also could be a potential hazard during orthopedic manipulations, hip joint surgery, and renal transplant surgery.

Persistent sciatic artery as collateral for an occluded iliofemoral system

“…Persistence of the sciatic artery is extremely rare. 1,2 This case appears to be the first reported instance in which the anomalous sciatic artery has served as an important collateral that has spared a patient from symptoms associated with acquired femoral artery occlusion (either embolic or atherosclerotic).…”

Intermediate and Long-Term Outcomes After Treating Symptomatic Persistent Sciatic Artery Using Different Techniques

“…[1][2][3][4] The incidence of bilateral PSAs in patients with PSA has been reported to range from 12 to 32%. 5 In patients with PSAs, two notable symptoms include a pulsatile or tender mass in the buttock related to a PSAA and intermittent claudication or rest pain because of LLI. We divided 67 limbs described in the 45 articles (published since 1965, written in English) dealing with symptomatic PSAs into three limb groups, LLI, PSAA, and LLI + PSAA (Table I).…”

Large-caliber persistent sciatic artery with aneurysm

“…The present case corresponds to type I of that classification, which is characterized by a well‐developed sciatic artery and extremely hypoplastic femoral artery. According to literature survey, the present case may be a typical PSA with regard to the pattern of branching, caliber of PSA and other complications such as aneurysm (Tohno et al ., 1993; Ikezawa, 1994; Savov & Wassilev, 2000). In contrast, compared with previous reports on the PSA, the present case is characterized by an extremely large caliber (13 mm, Table 1) with larger aneurysm (φ24 mm).…”