Hybrid approach in a case of persistent sciatic artery aneurysm

Area of Science:

• Vascular Surgery
• Congenital Malformations
• Interventional Radiology

Background:

• Persistent sciatic artery (PSA) is a rare congenital vascular anomaly.
• It is characterized by the sciatic artery remaining the dominant artery to the lower limb.
• PSA can be associated with aneurysmal degeneration.

Observation:

• An 82-year-old female presented with acute lower limb ischemia.
• Initial treatment involved popliteal embolectomy.
• Follow-up revealed a sciatic artery aneurysm (4.6 cm) with persistent sciatic artery.

Findings:

• A hybrid procedure combining femoropopliteal bypass and retrograde coil embolization of the aneurysm was performed.
• Distal sciatic artery ligation was also conducted.
• The patient remained asymptomatic post-procedure.

Implications:

• This case highlights a successful management strategy for a rare presentation of persistent sciatic artery aneurysm.
• Hybrid procedures offer a viable option for treating complex vascular malformations.
• Effective exclusion of the aneurysm and restoration of limb perfusion were achieved.