Persistent sciatic artery identified during prostatic artery embolization

A persistent sciatic artery (PSA) is a rare congenital vascular anomaly that may complicate endovascular pelvic procedures. We report a case of PSA incidentally identified during prostatic artery embolization in a patient with symptomatic benign prostatic hyperplasia. Angiography revealed a dominant PSA continuing from the common iliac artery through the sciatic notch, supplying the gluteal branches and internal pudendal artery, with hypoplasia of the superficial femoral artery. The ipsilateral prostatic artery originated from the internal pudendal branch of the PSA. Awareness of PSA is critical during pelvic embolization because of its atypical anatomy, potential aneurysmal degeneration, and implications for safe catheter navigation. This case highlights the importance of recognizing PSA to avoid procedural complications and to ensure accurate identification of the prostatic arterial supply.