Abstract
An 82-year-old man complaning about paresthesia in both thighs had a pathologic Doppler ultrasound, with monophasic waveform and reduced velocity in the left common femoral artery. Downstream left segment and in the right lower limb the flow was triphasics. There was no evidence for atherosclerotic disease. He was referred to perform an angiography-CT scan. Arterial phase contrast-enhanced MDCT with multiplanar reformation (MPR) and 3-D surface-rendered image showed an absence of the left external iliac artery in front of the left external iliac vein (Fig. A). The left common femoral artery is corretly opacified, reconstituted from a persistant sciatic artery (Fig. B) (suggested by an abnormal artery running posterior to the pelvis), a left obturator artery (Fig. C, arrowhead), an ilio-lumbar artery (Fig. C, arrow).
Highlights
3-D surface-rendered image showed an absence of the left external iliac artery in front of the left external iliac vein (Fig. A)
Most reported cases have been iliofemoral aplasia associated with persistent sciatic artery (PSA) or atresia with residual cord
The second presentation is the incomplete PSA, where PSA is hypoplastic and communicates via collateral vessels with the femoral artery
Summary
3-D surface-rendered image showed an absence of the left external iliac artery in front of the left external iliac vein (Fig. A). The left common femoral artery is corretly opacified, reconstituted from a persistant sciatic artery (Fig. B) (suggested by an abnormal artery running posterior to the pelvis), a left obturator artery arrowhead), an ilio-lumbar artery (Fig. C, arrow). Congenital anomalies of the iliac and femoral vessels are rare and usually discovered incidentally.
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