Persistent sciatic artery: two case reports and a review of the literature

Persistent sciatic artery (PSA) sometimes shows variant vascular symptoms such as chronic or acute limb ischaemia and a pulsatile mass in the buttocks caused by aneurysmal dilatation. This report presents two cases of surgically treated PSA that caused lower-limb ischaemia. The first patient, a 58-year-old man, showed acute limb ischaemia in the chronic clinical course, and thrombectomy and patch angioplasty were performed. The second patient, a 70-year-old woman, had an incomplete type of PSA without development of the femoral artery while complaining of a 10-year history of coldness and numbness in the left lower limb. A left common iliac to profunda femoris arterial bypass was performed. This is the second case of symptomatic incomplete PSA reported in the literature. This report also reviews 45 cases of PSA published since 1977. The diagnosis of PSA requires arteriography that includes the bilateral iliac systems. Femoropopliteal bypass and, in the case of sciatic artery aneurysm, a ligature of the sciatic artery are recommended for the surgical treatment of PSA.