Clinical aspects of persistent sciatic artery: report of two cases and review of the literature.

The sciatic artery is the principal blood supply to the lower extremity in the human embryo prior to the development of the femoral artery. Persistence of the sciatic artery in the adult is a rare albeit well documented anomaly with at least 29 cases reported in the world's literature and two additional cases presented here. The persistent sciatic artery is a branch of the internal iliac artery. It leaves the pelvis in close proximity with the sciatic nerve and is continuous with the popliteal artery. The superficial femoral artery usually is present and hypoplastic and only sends collaterals to the popliteal artery. Diagnosis of a patent sciatic artery is suggested by auscultation with a Doppler ultrasound and confirmed by autography. Obstruction and/or aneurysms of the sciatic artery should be treated with a femoral to popliteal or other distal artery bypass and ligation of the aneurysm if one is present.