Sánchez-Salinas MN, Paredes-Roberto R, Villanueva-Morales RH, González-Pérez LG, Carbajal V, León JI, Palomares-Vásquez ÓA

Language: Spanish
References: 17
Page: 180-185
PDF size: 261.87 Kb.

ABSTRACT

Background. The arteriomegaly of the persistent sciatic artery has been observed in several cases. The aneurysmatic dilation of the persistent sciatic artery was reported for the first time in 1864 by Fagge. The incidence of aneurysms formation in the PSA is about 44%, the average age at the diagnosis is 44, and 53 for aneurysmatic degeneration. During the first phases of embryologic development, the blood supply to the lower limb is provided by the sciatic artery, born from the umbilical artery. The persistent sciatic artery is an uncommon anomaly, with an incidence of 0.01 and 0.05%, and in 20% of the cases is bilateral. The persistent sciatic artery (PSA) originates from the hypogastric artery, goes to the gluteus region through the sciatic notch and follows through the posterior side of the thigh, and keep on to the popliteal artery. This anomaly may remain asymptomatic for many years, the aneurysmatic degeneration at the gluteus region, and aneurysm thrombosis as distal embolization, remain the most frequent complications reported, and with less frequency sciatic nerve compression.
Material and methods. Sixty-seven year old male patient, initiates with acute arterial insufficiency in the left lower limb, due to an aneurysm of the persistent sciatic artery, treated in the Hospital Centro Médico Nacional Siglo XXI, IMSS, underwent aneurysmectomy of the persistent sciatic artery with ringed polytetrafluorethylene graft of 8 mm.
Results. Patient underwent surgical procedure in January 2012, with acceptable post-chirurgical evolution, grade 2 femoral and popliteal pulses, distal pulses grade 1, currently without signs of vascular claudication.
Conclusions. Among the causes of acute arterial insufficiency (AAI), the atherosclerotic and embolic disease are found, as the presence of embryonic vascular malformations being the persistent sciatic artery an uncommon cause of this pathology. It must be suspected in young patients that initiates with AAI and a history of claudication, must know how to diagnose, and the prompt treatment for the limb salvage.

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