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Role of computed tomographic angiography in the detection and comprehensive evaluation of persistent sciatic artery Ah Young Jung, MD, Whal Lee, MD, Jin Wook Chung, MD, Soon-Young Song, MD, Sang Joon Kim, MD, Jongwon Ha, MD, Hwan Jun Jae, MD, Jae Hyung Park, MD Journal of Vascular Surgery Volume 42, Issue 4, Pages (October 2005) DOI: /j.jvs Copyright © 2005 The Society for Vascular Surgery Terms and Conditions
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Fig 1 Computed tomographic angiography of a left persistent sciatic artery (PSA) in a 66-year-old woman with left leg claudication and pain. A, Maximum intensity projection image after bone segmentation shows the typical appearance of a left PSA as an abnormal tortuous extension of the left internal iliac artery that continues as the popliteal artery. The left superficial femoral artery is hypoplastic, and distal thromboembolism is present in the tibioperoneal trunk and anterior tibial artery (arrowhead). The contralateral side shows the normal anatomy of lower-extremity arteries (arrows). B, Posterior view of volume rendering image shows the left PSA (arrows) passing through the sciatic notch (arrowhead) and running posteriorly to ischial bone. C, Curved multiplanar image shows the cross section of the entire lumen of the PSA and the presence of thromboembolism at the tibioperoneal trunk (arrowhead). Journal of Vascular Surgery , DOI: ( /j.jvs ) Copyright © 2005 The Society for Vascular Surgery Terms and Conditions
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Fig 2 Occluded persistent sciatic artery (PSA) in a 62-year-old woman with right lower leg pain. A, Maximum intensity projection image after bone segmentation does not show the tortuous PSA as in Fig 1, but instead demonstrates the collateral artery from the deep femoral artery to the popliteal artery (arrow) and the distal stump of the occluded PSA (arrowhead). B, Volume rendering image with left posterior oblique view angle shows the distal stump of the occluded PSA more vividly (arrowheads). Tortuous collateral artery (arrow) from the deep femoral artery is also demonstrated. C, Axial image at the level of upper thigh demonstrates PSA occluded with thrombus (arrowhead). Journal of Vascular Surgery , DOI: ( /j.jvs ) Copyright © 2005 The Society for Vascular Surgery Terms and Conditions
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Fig 3 Occluded persistent sciatic artery (PSA) with aneurysm formation in a 54-year-old woman with left leg claudication and pallor. Axial images show a 29 × 23 mm partially thrombosed PSA aneurysm. The aneurysm increased in size on this follow-up study compared with the initial CT angiography a year before this study (not shown). Coil embolization of the proximal stump of the PSA was done (not shown). Journal of Vascular Surgery , DOI: ( /j.jvs ) Copyright © 2005 The Society for Vascular Surgery Terms and Conditions
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Fig 4 Balanced venous drainage of persistent sciatic vein and communicating vein in a 54-year-old woman. One stream of the left popliteal vein runs cranially along the posterior aspect of femur and continues as deep femoral vein (black arrowheads), whereas another stream of vein (white stars) courses along the course of the left persistent sciatic artery (PSA) (white arrowheads), which drain to the internal iliac vein. Note atherosclerotic change and calcification (white arrow) of left PSA at mid-thigh level. Journal of Vascular Surgery , DOI: ( /j.jvs ) Copyright © 2005 The Society for Vascular Surgery Terms and Conditions
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