Persistent sciatic artery.
Persistent sciatic artery (PSA) is a very uncommon congenital malformation. Its incidence is estimated to be 0.025-0.04%. If it is accompanied by hypoplasia of the femoral artery system, its presence is essential for perfusion of the limbs. The usual form of presentation is as an aneurysm (25-58%) and/or its complications (thrombosis, distal remobilization, local compression). A 66-year-old woman presented with a painful mass of several months' progression. After performing angio-computed tomography, a fusiform aneurysmal dilation was observed in the left gluteal mass dependent on the left obturator artery, which was identified as the left lower gluteal artery. For this reason, we decided to perform therapeutic embolization. During the angiogram, a left aneurysmal PSA with distal thrombosis was observed. In view of these findings, a bypass from the superficial femoral artery to the tibioperoneal trunk was performed, with a contralateral inverted saphenous vein. The PSA was subsequently embolized with an occluder (AGA Medical IZASA, Plymouth, MN). The patient was discharged after checking complete exclusion of the aneurysm by ultrasound, with distal pulses during follow-up. Combined treatment using embolization, before surgical revascularization of the limb, markedly decreases the morbidity and mortality by avoiding the pelvic approach by the posterior route.
Santaolalla
Victoria
V
Angiology and Vascular Surgery, Hospital General Yagüe, Burgos, Spain. sanallah@hotmail.com
Bernabe
Monica Herrero
MH
Hipola Ulecia
Jose Maria
JM
De Loyola Agundez Gomez
Ignacio
I
Hoyos
Yolanda Gallardo
YG
Otero
Francisco Javier Mateos
FJ
Mendizabal
Ruben Franklin Montero
RF
Maldonado
Francisco Jose Medina
FJ
Legrand
Juan Luis Fonseca
JL
D000368:Aged; D000783:Aneurysm / Q000000981:diagnostic imaging / Q000209:etiology* / Q000628:therapy; D001158:Arteries / Q000002:abnormalities* / Q000601:surgery; D002081:Buttocks / Q000098:blood supply*; D004621:Embolization, Therapeutic / Q000295:instrumentation; D005260:Female; D005263:Femoral Artery / Q000002:abnormalities; D006801:Humans; D035002:Lower Extremity / Q000098:blood supply*; D012501:Saphenous Vein / Q000637:transplantation; D055989:Septal Occluder Device; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome; D054079:Vascular Malformations / Q000150:complications* / Q000000981:diagnostic imaging / Q000628:therapy