Aortic quadfurcation with persistent left sciatic artery: an extremely rare anatomic variant in a 3-year-old boy

Abstract

Reports of aortoiliac variant anatomy are rare, especially in the pediatric population. A 3-year-old male patient with hypertension and left foot polydactyly with syndactyly was referred to our interventional radiology service for evaluation of a possible renovascular cause of the hypertension. Angiograms revealed an extremely rare anatomic variant consisting of the absence of the common iliac arteries bilaterally, resulting from quadfurcation of the abdominal aorta into the bilateral internal and external iliac arteries. Additionally, a persistent left sciatic artery was identified.

Terminal quadrifurcation of the aorta: A case report

“…Variations to the configuration of the terminal aorta and iliac arteries are far rarer than the thoracic aorta and complete failure of bilateral common iliac arteries formation is extremely rare. 5 , 7 The incidence of distal aortic and iliac anomalies is unknown, however, a study of 8000 patients performed by Grebe and colleagues revealed only six cases with iliofemoral anomalies. 8 , 9 …”

Modified adaption of iliac branch endografts in rare congenital anomaly of proximal origin of bilateral internal iliac arteries

“… 1 Of these, only several cases of proximal origin of internal iliac arteries (IIAs) have been reported. 1 , 2 , 3 , 4 , 5 , 6 , 7 Coincidence of this congenital anomaly with abdominal aortic aneurysms (AAAs) makes endovascular repair quite challenging. Very short or no common iliac artery (CIA) inappropriate for distal landing zones 6 , 8 can lead to interruption of IIA and resultant ischemic complications.…”