Intermittent claudication associated with persistent sciatic artery: Report of two cases |
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Authors: | Masafumi Yamaguchi Shinsuke Mii Takashi Kai Hisanobu Sakata Akira Mori |
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Institution: | (1) Department of Surgery, Nippon Steel Corporation Yawata Works Hospital, 1-1-1 Harunomachi, Yahatahigashi-ku, 805 Kitakyushu-city, Japan |
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Abstract: | 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. |
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Keywords: | persistent sciatic artery aneurysm intermittent claudication |
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