Embolization of a sciatic artery aneurysm an alternative to surgery: a case report

An elderly woman was admitted with a 2-day history of pain, numbness and coolness of the left lower limb. The left foot on examination was cool and blue with no palpable pulse nor motor or sensory function. An arteriogram demonstrated a dilated persistent sciatic artery. The superficial femoral artery was hypoplastic and there was poor visualization of the distal circulation. At surgery an occluded popliteal artery was found. Attempts to open the occluded artery were unsuccessful and a left fibulectomy and fasciotomy was performed and the patient started on intravenous heparin. The patient's condition deteriorated and on the 4th hospital day an above-knee amputation was undertaken. The patient made an uneventful recovery and was subsequently discharged. At follow-up a month later the aneurysm was still patent and strongly pulsatile. She was readmitted to the hospital and the aneurysm was successfully embolized.