Persistent sciatic vein: Diagnosis and treatment of a rare condition

• Published in: Journal of vascular surgery Vol. 23; no. 3; pp. 490 - 497
• Main Authors: Cherry, Kenneth J., Gloviczki, Peter, Stanson, Anthony W.
• Format: Journal Article Conference Proceeding
• Language: English
• Published: New York, NY Mosby, Inc 01.03.1996; Elsevier
• Subjects: Adolescent; Adult; Aged; Arteriovenous Malformations - diagnosis; Biological and medical sciences; Blood and lymphatic vessels; Buttocks - blood supply; Cardiology. Vascular system; Child; Child, Preschool; Diseases of the peripheral vessels. Diseases of the vena cava. Miscellaneous; Female; Humans; Klippel-Trenaunay-Weber Syndrome - diagnosis; Magnetic Resonance Angiography; Male; Medical sciences; Middle Aged; Phlebography; Thigh - blood supply; Veins - abnormalities; Human; Radiodiagnosis; Indication; Cardiovascular disease; Congenital disease; Nuclear magnetic resonance imaging; Venous disease; Phlebography; Vascular disease; Persistence; Treatment; Malformation; Diagnosis
• ISSN: 0741-5214; 1097-6809
• DOI: 10.1016/S0741-5214(96)80016-4

Purpose: Persistent sciatic vein (PSV) is a rare anomaly most often associated with Klippel-Trenaunay Syndrome (KTS). Magnetic resonance imaging (MRI) and extended use of phlebography have increased the frequency of diagnosis. To evaluate our experience, we reviewed patients in whom PSV was diagnosed at our institution. Methods: MRIs and phlebograms of all patients with KTS seen since 1985 were reviewed, and patients with PSV were identified. Results: Forty-one of 186 patients with KTS underwent MRI. PSV was diagnosed in 20 of the 41 (48.8%). In addition, one other patient without KTS had PSV. Thirteen patients (61.9%) were female. Patient age ranged from 5 to 71 years, with a median age of 22 years. PSVs were present in the entire thigh and buttock of eight patients (38.1%), the upper thigh and buttock of six patients (28.6%), and the lower thigh of seven patients (33.3%). Six patients (28.6%) had anorectal arteriovenous malformations with heavy bleeding. Five patients (23.8%) had pulmonary embolization. Two patients (9.5%) died. Amputation was required in one (4.8%). Nineteen patients (90.5%) underwent no specific surgery for PSV. Two patients (9.5%) underwent successful excision of PSVs. Conclusion: Excision of PSV appears to be rarely indicated. It may be indicated for localized symptoms in patients whose condition and anatomy permit. PSV may be a marker for patients with more extensive arteriovenous malformations and for those at high risk for rectal bleeding and pulmonary embolization. Prognosis is related to the associated vascular malformations. MRI and extended use of phlebography should increase the frequency of diagnosis. Treatment rationales should evolve.