Persistent sciatic artery

A persistent sciatic artery is a rare vascular anomaly where there is the continuation of the internal iliac artery into the thigh through the greater sciatic notch. It may be the dominant artery supplying the leg, in which case the superficial femoral artery may be small.

Its incidence is in 0.05% of the population and may be bilateral in up to 20% of cases 5.

  • Cowie's sign: described as a diminished or absent femoral pulse in combination with a palpable popliteal pulse
    • considered to be pathognomonic for a persistent sciatic artery 4

A superficial course through the buttock renders the persistent sciatic artery susceptible to repetitive trauma from sitting and hip flexion-extension. This, coupled with congenital arterial wall hypoplasia, can result in early atherosclerosis and aneurysm formation. An aneurysm, in turn, can compress the adjacent sciatic nerve. As with any aneurysm, it can also rupture 5.

Anatomy: Abdominopelvic
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Article information

rID: 7398
System: Vascular
Section: Anatomy
Tag: cases, cases
Synonyms or Alternate Spellings:
  • Persistent sciatic arteries

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Cases and figures

  • Case 1
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  • Case 2: bilateral
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