Persistência da artéria isquiática: relato de caso

Abstract

Persistent sciatic artery is a rare congenital anomaly of the circulatory system. Since there are few cases described in the literature, there is no consensus on diagnostic and treatment methods. The authors report on a 59-year-old male patient with history of progressive intermittent claudication in the right calf, associated with pulsatile mass in the popliteal fossa and absence of distal pulses. Tomography angiography of the abdominal aorta and lower limbs showed persistent right sciatic artery. Selective digital subtraction angiography of the sciatic artery was also performed for surgical planning. The patient was submitted to femorofibular bypass with reverse ipsilateral great saphenous vein and ligation of the sciatic artery in the pelvis using retroperitoneal approach.Key words: Persistent sciatic artery, sciatic artery aneurysm, surgical correction, peripheral ischemia. ResumoA persistência da artéria isquiática é uma anomalia congênita rara do sistema circulatório, sendo descritos poucos casos na literatura e não existindo, assim, consenso sobre métodos diagnósticos e de tratamento. Os autores apresentam o caso de um paciente masculino, de 59 anos de idade, com história de dor tipo "claudicação intermitente" progressiva em panturrilha direita, associada a uma massa pulsátil em fossa poplítea e ausência de pulsos distais. A angiotomografia da aorta abdominal e dos membros inferiores revelou persistência da artéria isquiática à direita, sendo realizada, ainda, angiografia com subtração digital seletiva da artéria isquiática para o planejamento cirúrgico. O paciente foi submetido à ponte fêmoro-fibular com veia safena magna ipsolateral reversa e ligadura da artéria isquiática na pelve, por acesso retroperitoneal.Palavras-chave: Persistência da artéria isquiática, aneurisma da artéria isquiática, terapêutica cirúrgica, isquemia periférica. RELATO DE CASO

Diagnóstico e tratamento de aneurisma da artéria isquiática persistente: relato de caso e revisão da literatura

“…11 Mayschak & Flye 2 reported that most cases found in their study included complete sciatic artery. Our study corroborates the reports performed by Dias et al, 6 Oliveira et al, 7 Araújo et al 8 and Bez et al, 9 and we found the complete type.…”

“…Araújo et al 8 described one bilateral case. Dias et al 6 and Bez et al 9 found persistence in the right lower limb, and Oliveira et al 7 in the left lower limb. In our case, there was no bilaterality in persistent sciatic artery.…”

“…Studies carried out by Brazilian authors reported cases including age and gender. Thus, Dias et al, 6 Oliveira et al, 7 Araújo et al 8 and Bez et al 9 described a variation between 58-74 years, with mean of 64.25 years, three cases being in women [6][7][8] and only one in the male gender. 9 Age ranged between 42-82 for Maldini et al, 10 with mean of 62 years.…”

Angioplasty of a persistent sciatic artery: case report

“…They are bilateral in 12-32% of the cases 4,5 . This anomaly also predisposes to early atheromatous degeneration, distal thromboembolism and arterial occlusion 6 . Percutaneous transluminal balloon angioplasty is a well established technique for treating significant stenosis and short occlusions.…”

Aneurisma de artéria isquiática persistente: relato de caso

“…However, in its complete form, lower limb revascularization is recommended, associated with exclusion. 8,12 Bez et al 13 reported a case in which the sciatic artery was completely aneurysmal until the popliteal artery, which required surgical treatment with femorofibular revascularization using the saphenous vein associated with sciatic artery ligation.…”