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BACKGROUND - Persistent sciatic artery is a rare congenital anomaly that is prone to aneurysm formation. We present a novel treatment for persistent sciatic artery aneurysms.
METHODS - Preoperative imaging was performed and reviewed identifying a patient with a persistent sciatic artery aneurysm.
RESULTS - Persistent sciatic artery is a rare developmental anomaly. In its complete form, it provides the major arterial supply to the lower leg and the femoral system is hypoplastic. These are prone to aneurysm formation and most commonly present with complications related to the aneurysm. We report a case of a 68-year-old male who presented with bilateral lower extremity pain and was found to have bilateral persistent sciatic artery aneurysms on CTA. One side had already thrombosed, but the other was noted to still be patent. We treated this patient with a combined open and endovascular repair on the side that was still patent. The aneurysm was excluded with an Amplatzer plug followed by a femoropopliteal bypass with saphenous vein to restore flow to the lower leg.
CONCLUSIONS - To our knowledge, this is the second report of a persistent sciatic artery aneurysm treated with Amplatzer plug occlusion, which we believe should be the preferred method of aneurysm exclusion.