title: Clinical outcome after surgical and endovascular treatment of symptomatic persistent sciatic artery with review of the literature and reporting of three cases.
abstract: A persistent sciatic artery is a very rare vascular anomaly with an estimated incidence of 0.025-0.06% and with less than 200 described cases in the literature. During early embryonic development, the sciatic artery delivers the major blood supply to the lower limb and usually disappears when the superficial femoral artery has developed properly. The usual form of presentation in adults is the aneurysmal degeneration of the sciatic artery or less frequently with another complication (thrombosis, embolism, neuralgia). We describe three cases of a complete sciatic artery (two cases are bilateral and one is unilateral) associated with lower limb ischemia caused by embolism from the aneurysmal degeneration of the sciatic artery at the buttock level in two cases and atherosclerotic degeneration of the lower limb arteries in the third case. We also describe two combined therapy methods consisted of limb revascularization with vein-graft bypass and endovascular embolization of the aneurysm with vascular plug in the first case, in the second case combination of localized thrombolysis therapy followed by a bypass and an ilio-pedal vein bypass in the third one. And we discuss later the reported clinical outcome after surgical and endovascular treatment of this anomaly in the literature.
authors.affiliation: Department of Vascular and Endovascular Surgery, University Hospital of Cologne, Cologne, Germany waelsahmad@gmail.com.
authors.forename: Wael
authors.initials: W
authors.lastname: Ahmad
authors.affiliation: Department of Vascular and Endovascular Surgery, University Hospital of Cologne, Cologne, Germany.
authors.forename: Payman
authors.initials: P
authors.lastname: Majd
authors.affiliation: Department of Vascular and Endovascular Surgery, University Hospital of Cologne, Cologne, Germany.
authors.forename: Thomas
authors.initials: T
authors.lastname: Luebke
authors.affiliation: Department of Vascular and Endovascular Surgery, University Hospital of Cologne, Cologne, Germany.
authors.forename: Michael
authors.initials: M
authors.lastname: Gawenda
authors.affiliation: Department of Vascular and Endovascular Surgery, University Hospital of Cologne, Cologne, Germany.
authors.forename: Jan Sigge
authors.initials: JS
authors.lastname: Brunkwall
mesh_terms: D000368:Aged; D000783:Aneurysm / Q000150:complications / Q000000981:diagnostic imaging / Q000601:surgery / Q000628:therapy*; D015901:Angiography, Digital Subtraction; D055109:Ankle Brachial Index; D001158:Arteries / Q000002:abnormalities / Q000000981:diagnostic imaging / Q000601:surgery*; D050197:Atherosclerosis / Q000150:complications / Q000000981:diagnostic imaging / Q000601:surgery / Q000628:therapy*; D000072226:Computed Tomography Angiography; D004617:Embolism / Q000000981:diagnostic imaging / Q000209:etiology / Q000601:surgery / Q000628:therapy*; D004621:Embolization, Therapeutic; D057510:Endovascular Procedures; D005260:Female; D006801:Humans; D007511:Ischemia / Q000000981:diagnostic imaging / Q000209:etiology / Q000601:surgery / Q000628:therapy*; D035002:Lower Extremity / Q000098:blood supply*; D008297:Male; D008875:Middle Aged; D015912:Thrombolytic Therapy; D016896:Treatment Outcome; D054079:Vascular Malformations / Q000150:complications* / Q000000981:diagnostic imaging; D014680:Veins / Q000637:transplantation*
keywords: Persistent sciatic artery; aneurysm; endovascular therapy