Jornal Vascular Brasileiro
https://www.jvascbras.org/article/doi/10.1590/S1677-54492011000300013
Jornal Vascular Brasileiro
Case Report

Tratamento cirúrgico de pseudoaneurisma de artéria isquiática: relato de caso e revisão da literatura

Surgical treatment of false aneurysm of the sciatic artery: case report and literature review

Gustavo Ioshio Handa; Francisco Eduardo Coral; Vinicius Zendrini Buzingnani; Lucas Marques Mantovani; Elizana Stella Lopes Rasera; Denise Krauss; Maria Carolina S. de Paula

http://dx.doi.org/10.1590/S1677-54492011000300013 J Vasc Bras, vol.10, n3, p.256-260, 2011
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Resumo

A persistência da artéria isquiática é uma rara variação anatômica, com poucos casos descritos na literatura, manifestando-se por formação de aneurisma, massa pulsátil em glúteo, isquemia aguda ou crônica de membro inferior e compressão de nervo isquiático. O diagnóstico é confirmado com exames de imagem: mapeamento duplex, angiotomografia e angiorressonância magnética. O tratamento é indicado nos casos sintomáticos ou quando há formação de aneurisma, realizado através de ligadura ou embolização por via endovascular, sendo necessário a revascularização do membro nos casos em que a artéria isquiática é a principal responsável pelo suprimento sangüíneo do membro. Apresentamos o caso de uma paciente do sexo feminino, 43 anos, com pseudoaneurisma de artéria isquiática confirmada por mapeamento duplex e angiorressonância magnética, com quadro de neuropatia isquiática por compressão nervosa e dor local. A paciente foi submetida à exploração cirúrgica com ligadura da artéria isquiática e remoção dos trombos. No seguimento de 12 meses, apresentou importante melhora da dor e realizou fisioterapia motora para recuperação das funções neurológicas do membro.

Palavras-chave

neuropatia ciática, falso aneurisma, artéria ilíaca

Abstract

The persistent sciatic artery is a rare anatomical variation, with few cases described on the literature. It presents clinically as aneurysm formation, pulsate gluteal mass, acute or chronic limb ischemia and sciatic nerve compression. Diagnosis is confirmed by imaging methods: duplex scan, CT angiographt and magnetic resonance angiography. Treatment is indicated in symptomatic cases and when there is aneurysm formation and it is performed by ligation of the sciatic artery or endovascular embolization, associated with limb revascularization in the cases the sciatic artery is the main blood supply to the limb. We report the case of a 43 year-old female patient, ,with a false aneurysm of the sciatic artery confirmed by duplex scan and magnetic resonance angiography who had local pain and sciatic neuropathy due to neural compression. Surgical exploration was performed, with ligation of sciatic artery and thrombus removal. At the 12 months follow up there was significant pain relief and she was performing motor physical therapy to recover the neurological functions of the limb.

Keywords

sciatic neuropathy, aneurysm, false, iliac artery

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