Endovascular exclusion of a persistent sciatic artery aneurysm causing distal embolization

Persistent sciatic artery (PSA) is a rare congenital vascular anomaly that may be complicated by aneurysm formation and distal embolization. A 72-year-old woman presented with acute calf and foot pain despite preserved distal pulses. Computed tomography angiography revealed a complete PSA with aneurysmal degeneration and mural thrombus. Endovascular exclusion using a Viabahn covered stent achieved successful aneurysm exclusion and restoration of distal perfusion. This case demonstrates that endovascular repair is an effective treatment option for PSA aneurysm complicated by distal embolization, offering a safer alternative to open surgery in avoiding sciatic nerve injury.