Relato de caso: persistência da artéria isquiática completa bilateral associada à degeneração aneurismática
Case report: persistent bilateral complete sciatic artery associated with aneurysmal degeneration
Paulo Henrique Alves Togni Filho; André Luís Santos Vaz Leite; Marcela Prando Sampaio; Beatriz Camargo Castro; Henrique Tomaz Rodrigues; Guilherme Augusto Paro
Resumo
Palavras-chave
Abstract
Persistent sciatic artery is a rare congenital anomaly, with few cases described in the literature. This study presents a case of this embryological variation observed in a patient’s lower limb circulatory system. The anatomical description is based on a review of medical records and imaging exams. This case report describes a 63-year-old female patient admitted to the emergency department complaining of severe pain in the right lower limb, with a cold, pale extremity and ecchymosis on the dorsum of the foot. Duplex ultrasound showed no detectable flow in the anterior tibial and fibular arteries and a tardus parvus pattern in the posterior tibial artery. The patient developed loss of movement and fixed cyanosis in the right foot and was referred for urgent thromboembolectomy. However, adequate reperfusion was not seen after the procedure. Angiotomography was performed on the first postoperative day, showing bilateral persistence of the sciatic artery, with aneurysmal degeneration, partially thrombosed, and no opacification of the arterial system downstream of the aneurysm. By the third postoperative day, the patient had developed areas of dry necrosis in the limb, with no perfusion to the ankle, and underwent transfemoral amputation. Despite being a rare condition, it is of great clinical importance because of the high complication rates.
Keywords
References
1 Mann A, Liu E, Naji F. Persistent sciatic artery aneurysm presenting with acute limb ischemia: case report and review of the literature. Ann Vasc Surg Brief Rep Innov. 2022;2(2):100062.
2 Yang S, Ranum K, Malone M, Nazzal M. Bilateral persistent sciatic artery with aneurysm formation and review of the literature. Ann Vasc Surg. 2014;28(1):264.e1-7.
3 Morisaki K, Yamaoka T, Iwasa K, Kuma S, Okazaki J. Persistent sciatic artery aneurysm with limb ischemia: a report of two cases. Ann Vasc Dis. 2017;10(1):44-7.
4 Ito H, Okadome K, Odashiro T, et al. Persistent sciatic artery: two case reports and a review of the literature. Cardiovasc Surg. 1994;2(2):275-80. PMid:8049962.
5 Accarino G, Bracale U, Turchino D, et al. Hybrid treatment of persistent sciatic artery aneurysm: two cases, long term follow-up and literature review. Ann Vasc Surg Brief Rep Innov. 2023;3(1):100168.
6 Senior HD. An interpretation of the recorded arterial anomalies of the human pelvis and thigh. Am J Anat. 1925;36(1):1-46.
7 Noblet D, Gasmi T, Mikati A, Watel A, Warembourg H, Soots G. Persistent sciatic artery: case report, anatomy, and review of the literature. Ann Vasc Surg. 1988;2(4):390-6.
8 McLellan GL, Morettin LB. Persistent sciatic artery: clinical, surgical, and angiographic aspects. Arch Surg. 1982;117(6):817-22.
9 Brantley S, Rigdon E, Raju S. Persistent sciatic artery: embryology, pathology, and treatment. J Vasc Surg. 1993;18(2):242-8.
10 Williams LR, Flanigan DP, O’Connor RJ, Schuler JJ. Persistent sciatic artery: clinical aspects and operative management. Am J Surg. 1983;145(5):687-93.
11 Bower EB, Smullens SN, Parke WW. Clinical aspects of persistent sciatic artery: report of two cases and review of the literature. Surgery. 1977;81(5):588-95. PMid:850875.
12 Bez LG, Costa-Val R, Bastianetto P, et al. Persistência da artéria isquiática: relato de caso. J Vasc Bras. 2006;5(3):233-6.
13 van Hooft IM, Zeebregts CJ, van Sterkenburg SM, de Vries WR, Reijnen MM. The persistent sciatic artery. Eur J Vasc Endovasc Surg. 2009;37(5):585-91.
14 Belmir H, Hartung O, Azghari AS, Alimi Y, Lekehel B. The persistent sciatic artery: report of ten cases. J Med Vasc. 2020;45(5):241-7.
15 Jung AY, Lee W, Chung JW, et al. Role of computed tomographic angiography in the detection and comprehensive evaluation of persistent sciatic artery. J Vasc Surg. 2005;42(4):678-83.
16 Charisis N, Giannopoulos S, Tzavellas G, Tassiopoulos A, Koullias G. Endovascular treatment of persistent sciatic artery aneurysms with primary stenting: a systematic review of the literature. Vasc Endovascular Surg. 2020;54(3):264-71.
Submitted date:
10/20/2023
Accepted date:
03/17/2024
Facebook
Google+
Twitter
LinkedIn
Mendeley
StumbleUpon
CiteULike
Reddit
Email