Case Report: Persistent Sciatic Artery Preserves Limb Perfusion After Gunshot Wound
Matthew G. Spivey, MD, Daniel H. Newton, MD, Robert A. Larson, MD, RVT, FACS.
VCU Health, Richmond, VA, USA.
Objective
Persistent sciatic artery is a rare embryological variant that occurs as a result of a lack of regression of the embryological axial artery of the developing lower limb. Here we present the case of a 20 year old man fortunate to have this vascular anomaly.
Methods
Clinical data and imaging from the reported case were collected and reviewed. We describe the details of the patient's workup and the technical aspects of his operative intervention. A review of the relevant literature was conducted in order to derive learning points pertinent to the case.
Results
This report describes the case of a 20-year-old male who presented with bilateral superficial femoral artery (SFA) injuries from a gunshot wound. Despite thrombotic occlusion of the right SFA the patient's leg remained well perfused with an ABI of 1.0. He was found to have a right persistent sciatic artery that obviated the need for intervention to address the right SFA occlusion. His left SFA had a traumatic dissection that was treated with a covered stent.
Conclusion
Persistent sciatic artery is most often recognized when aneurysmal or thrombotic pathology causes it to become symptomatic or even limb threatening. In this case, the anomaly instead proved valuable to the patient whose traumatic injury may otherwise have required further urgent operative intervention and potentially led to far greater morbidity. 
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