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Aneurysm II: Clinical Manifestations and Diagnostic Studies01:21

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Thoracic, aortic arch and abdominal aneurysms are significant vascular conditions that can present with various clinical manifestations and lead to serious complications. Understanding these manifestations and the appropriate diagnostic studies is essential for effective management and treatment.Thoracic Aortic AneurysmsThoracic aortic aneurysms often remain asymptomatic until they reach a size that impinges on adjacent structures. They typically cause deep, diffuse chest pain that radiates to...
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Aneurysm management involves either conservative medical therapy or surgical intervention, depending on the size and symptoms of the aneurysm. Conservative management is generally reserved for smaller, asymptomatic aneurysms, while larger or symptomatic aneurysms often necessitate surgical repair.Conservative Medical TherapyFor small, asymptomatic aneurysms, particularly abdominal aortic aneurysms (AAA) less than 5.5 centimeters in diameter, conservative medical therapy is recommended. This...
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Clinical manifestationsPeripheral Arterial Disease (PAD) manifests through a range of symptoms, from the characteristic intermittent claudication to atypical presentations and severe complications in advanced stages. Intermittent claudication, a hallmark symptom of PAD, presents as exercise-induced muscle pain that typically resolves within minutes of rest. This pain is reproducible and stems from inadequate blood flow, leading to the accumulation of lactic acid produced during anaerobic...
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An aortic aneurysm is a localized outpouching or dilation at a weak point in the artery wall. It may involve different parts of the aorta, such as the abdominal aorta, aortic arch, or thoracic aorta.Etiological factorsSeveral disorders are associated with aortic aneurysms.Congenital causes, such as primary connective tissue disorders like Marfan syndrome, impact the integrity and strength of connective tissues, notably affecting the aorta. Marfan syndrome is a genetic disorder that specifically...
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Peripheral artery disease (PAD) predominantly results from atherosclerosis, which involves the accumulation of fatty deposits, or plaques, within the walls of arteries. This causes them to narrow and harden, significantly reducing blood flow. PAD predominantly affects the legs, particularly the arteries supplying the thighs and calves. In rare cases, it may involve other arteries, including those in the arms.Etiology of PAD:The principal cause of PAD is atherosclerosis, which results from fatty...
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Atherosclerosis is a progressive disorder that leads to the thickening and narrowing of arterial walls due to plaque buildup. This condition can cause various symptoms depending on the arteries affected:Coronary Artery Disease (CAD): This condition affects the coronary arteries and may lead to chest pain (angina), shortness of breath (dyspnea), heart attacks, and other heart disease symptoms.Cerebrovascular Disease: This affects blood flow to the brain, causing transient ischemic attacks (TIAs)...
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Rare Occurrence of a Symptomatic Persistent Sciatic Artery Aneurysm.

Hasnan M Ijaz1, Justin D Mark2, Muhammad Lodhi3

  • 1Internal Medicine, Hospital Corporation of America (HCA) Florida Westside Hospital, Plantation, USA.

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|December 21, 2022
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Summary

Persistent sciatic artery aneurysms, a rare vascular anomaly, can cause leg pain. Early diagnosis and hybrid surgical repair are crucial for preventing severe complications like amputation.

Keywords:
endovascular coilingendovascular techniqueir guided embolizationperipheral vascular surgerypersistent sciatic artery aneurysmvascular surgery

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Area of Science:

  • Vascular Surgery
  • Congenital Vascular Anomalies
  • Interventional Radiology

Background:

  • Persistent sciatic artery (PSA) is a rare congenital vascular anomaly.
  • PSA aneurysms are infrequent but serious complications, potentially leading to severe pain and limb-threatening events.
  • Early diagnosis is critical for effective management and prevention of complications.

Observation:

  • A 75-year-old female presented with gluteal and lower extremity pain, initially misdiagnosed as sciatica.
  • Diagnostic workup revealed a persistent sciatic artery aneurysm.
  • The patient experienced significant pain attributed to the aneurysm.

Findings:

  • The persistent sciatic artery aneurysm was successfully treated using a hybrid approach.
  • The procedure involved a femoral to below-knee popliteal artery bypass.
  • Coil embolization was performed at the aneurysm's proximal and distal ends.

Implications:

  • Hybrid open and endovascular techniques offer a viable solution for complex PSA aneurysms.
  • Successful treatment can alleviate pain and prevent limb-threatening complications.
  • This case highlights the importance of considering rare vascular anomalies in the differential diagnosis of lower extremity pain.