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Persistent sciatic artery aneurysm treated with concomitant tibial bypass and vascular plug embolization.

Ryan M McEnaney¹, Donald T Baril, Navyash Gupta

¹Division of Vascular Surgery, University of Pittsburgh Medical Center, Pittsburgh, PA 15213, USA.

Journal of Vascular Surgery

|June 30, 2009

Summary

Persistent sciatic artery aneurysm caused critical limb ischemia in an 82-year-old female. Treatment involved bypass surgery and embolization, successfully restoring blood flow.

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Area of Science:

Vascular Surgery
Congenital Malformations
Interventional Radiology

Background:

Persistent sciatic artery is a rare congenital vascular anomaly.
Aneurysmal degeneration can lead to severe complications like rupture or embolization.
Critical limb ischemia (CLI) significantly impacts patient morbidity.

Observation:

An 82-year-old female presented with CLI.
The cause was identified as embolization from a partially thrombosed persistent sciatic artery aneurysm.
This highlights a rare but serious presentation of this vascular malformation.

Findings:

Successful treatment was achieved through surgical intervention.
A common femoral to posterior tibial artery bypass using the great saphenous vein was performed.
Vascular plug embolization effectively managed the aneurysm.

Implications:

This case demonstrates a viable treatment strategy for limb-threatening ischemia caused by persistent sciatic artery aneurysms.
Highlights the importance of considering rare vascular anomalies in the differential diagnosis of CLI.
Successful revascularization and aneurysm exclusion can prevent further embolic events and preserve limb function.