[Persistent sciatic artery: a case report].

Area of Science:

• Vascular anatomy
• Embryology
• Medical imaging

Background:

• The sciatic artery is the primary embryonic blood supply to the lower limb, typically regressing by the third month of development.
• Persistence into adulthood is rare and can lead to complications like aneurysms, embolism, nerve compression, rupture, and thrombosis.
• The persistent proximal sciatic artery usually becomes the inferior gluteal artery.

Observation:

• A 48-year-old male presented for lower extremity angiography prior to orthopedic surgery.
• Angiography revealed a hypoplastic superficial femoral artery and a large persistent sciatic artery (PSA) originating from the internal iliac artery.
• The PSA ran distally, overlapping the deep femoral artery, with no signs of aneurysm or stenosis.

Findings:

• The study identified a rare case of a large, non-aneurysmal, non-stenotic persistent sciatic artery (PSA) in an adult.
• The PSA originated from the internal iliac artery and ran distally, with a hypoplastic superficial femoral artery noted concurrently.
• This finding highlights a significant anatomical variation in lower limb vasculature.

Implications:

• Stable patients with a persistent sciatic artery (PSA) require follow-up with ultrasound every 12 months.
• Treatment decisions for PSA should consider whether the artery is completely or incompletely persistent.
• Early detection and monitoring are crucial for managing potential complications associated with this rare vascular anomaly.