Large-caliber persistent sciatic artery with aneurysm

Abstract

Herein is reported a rare case of right persistent sciatic artery (PSA) in the cadaver of a 96-year-old woman who did not have any clinical manifestations related to this anomaly when alive. The anomalous PSA originated from the internal iliac artery, directed toward the infrapiriform foramen, and descended the dorsal side of the thigh. Approximately 20 mm inferior to the infrapiriform foramen, the PSA formed a relatively large aneurysm elongating for approximately 30 mm in length. It then passed under the long head of the femoral biceps muscles, and reached the popliteal fossa, maintaining a constant caliber (approx. 13 mm) as it went down distally. In contrast, the femoral artery was very narrow, and tapered at the level of the knee joint. In addition, the popliteal vein gave rise to two branches, one ran along with the sciatic artery and the other pierced the adductor muscles, and appeared on the ventral side of the thigh. It then drained into the deep femoral vein, which reached the pelvis via the femoral vein. The present case is an interesting example for clinicians who work in pelvic surgery.

A Case of Persistent Sciatic Artery Aneurysm Accompanied by a Persistent Sciatic Vein

“…5,6,8,9) A persistent sciatic artery is susceptible to atherosclerosis, and aneurysm formation is observed in 14-48% of the cases. 4,5) This is considered to be because this artery runs near the surface layer in the buttocks and tends to be subjected to blunt external forces, but there is no definitive evidence. 9) Persistent sciatic arteries are classified into the complete type that continues to the popliteal artery, supplying blood to the leg, and the incomplete type without communication with the popliteal artery.…”

“…1,3,4) About 30% of the cases are bilateral, 3,5) and the anomaly is congenital. Its diagnosis is made at about the age of 50 years in most cases, and there are no sex-related differences.…”

“…6) Aneurysm formation is observed in about 40% of such cases. 4,5) The sciatic artery is a major blood supply vessel for the lower limbs in embryos 6 mm in length. In the 18-mm embryo stage, the femoral artery system becomes the predominant blood supply system.…”

“…[1][2][3][4] We report a patient in whom a right persistent sciatic vein was detected by computed tomography (CT) during treatment for a right persistent sciatic artery aneurysm, with a brief review of the literature.…”

Aneurisma de la arteria ciática persistente con isquemia secundaria de la extremidad, revisión de la literatura y reporte de un caso

“…Se origina en la arteria umbilical y es la principal fuente de aporte sanguíneo a la extremidad inferior durante las primeras semanas de gestación hasta su regresión, cuando aparece la arteria femoral superficial 1,2 . La arteria ciática persistente es una anomalía congénita poco frecuente que puede cursar asintomática o manifestarse como una masa pulsátil en el glúteo, por isquemia aguda de la extremidad, o con un dolor ciático con radiculopatía o sin ella 3 .…”