Title:Persistent Sciatic Artery with Peripheral Arterial Disease: A Case Report
Volume: 19
Author(s): José David Cardona Ortegón*, María Mónica Yepes, Oscar Mauricio Rivero Rapalino, David Fernando Torres Cortes, Gonzalo Andres Montaño Rozo and Luisa Maria Muñoz Quiroga
Affiliation:
- Department of Diagnostic Imaging, Fundación Santa Fe de Bogotá, Bogotá, Colombia
Keywords:
Peripheral arterial disease, incidental finding, anatomical variant, persistent sciatic artery, angiotomography, peripheral vascular disease.
Abstract:
Background: Persistent sciatic artery (PSA) is a congenital malformation due to incomplete
involution during the embryonic period. Its etiology is unknown, with an estimated incidence of 0.02 -
0.04% in the whole population and a mean age of 60-65 years. Its presentation can be bilateral. It is
asymptomatic in most cases and is usually detected accidentally; however, some symptoms may appear,
such as claudication, sciatic neuralgia, and pain in the affected limb. It can also manifest as an
aneurysmal dilatation or thrombosis that can generate distal embolism with ischemia.
Case Report: In this case study, a patient in her 90s with a suspected peripheral arterial disease, which
required an angiotomography of the lower limb, showing a superficial femoral artery running to the
middle and distal third of the thigh and a vascular structure running in the sciatic neurovascular bundle
corresponding to a persistent sciatic artery presenting atherosclerotic changes and extensive occlusion,
was presented. The patient's treatment was clinical with dual antiplatelet therapy and prophylactic anticoagulation.
This was due to comorbidities and age. Moreover, the PSA occlusion was not critical and
did not significantly impact the patient's quality of life.
Conclusion: Most patients with this anatomical variant are asymptomatic all their lives, but some of
them may present symptoms with serious consequences. It is important to suspect it by clinical presentation
and perform diagnostic confirmation by angiotomography. Treatment has yielded excellent results
with endovascular techniques. Certain patients only require conservative treatment with anticoagulants
and antiplatelet agents.
