Persistent sciatic artery

Case contributed by Dalia Ibrahim
Diagnosis certain

Presentation

Right lower limb claudication.

Patient Data

Age: 60 years
Gender: Male
ct

Persistent right sciatic artery continuing as the popliteal artery (complete type), associated with partially thrombosed pseudoaneurysm opposite the right ischial tuberosity.

Persistent left sciatic artery, diminishing distally (not continuous with the popliteal artery), in keeping with the incomplete type. On this side, the superficial femoral artery is continuous with the popliteal artery.

Distally, there are occluded popliteal arteries on both sides at their distalmost segments, with occluded anterior and posterior tibial arteries on both sides and collateral refilling of the peroneal arteries on both sides.

Case Discussion

Persistent sciatic artery represents a continuation of the internal iliac artery into the thigh through the greater sciatic foramen below the piriformis muscle, through the thigh, alongside the sciatic nerve.

This case includes the two types of persistent sciatic artery:

  • the complete type on the right side, where the persistent sciatic artery is continuous as the popliteal artery, while the superficial and deep femoral arteries appear small
  • the incomplete type on the left side, where the persistent sciatic artery diminishes toward the calf, while the superficial femoral artery continues as the popliteal artery

Additionally, there is a right partially thrombosed pseudoaneurysm of the sciatic artery opposite the ischial tuberosity, which is a common finding secondary to repeated trauma from sitting and hip flexion-extension.

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