A persistent sciatic artery aneurysm containing a free-floating thrombus: report of a case

Abstract

A persistent sciatic artery is a rare vascular anomaly in which the sciatic artery, which involutes in the embryonic stage, persists as the blood supply to the lower limb. This vascular anomaly is often associated with aneurysm formation. A persistent sciatic artery aneurysm is a rare cause of peripheral arterial embolic disease. We herein describe the case of a 72-year-old female with a free-floating thrombus in a persistent sciatic artery aneurysm. She underwent iliac-popliteal artery bypass and exclusion of the aneurysm to prevent an embolic event.

From diagnosis to treatment of persistent sciatic artery: a revised review of the literature

“…Leg pain is reported in 31.3% of the patients and it is often related to thromboembolism which may arise from the aneurysm. [11] The emboli, which arise from an aneurysm or are associated with PSA has been reported in 20% patients, while the leg pain caused by an arterial stenosis was reported in 10% of patients. [2] Moreover, neurological symptoms such as radicular pain and drop foot may occur in patients with PSA, due to the location of PSA adjacent to the sciatic and L5-S1 radicular nerve.…”

“…[2] Ilio-or femoro-popliteal bypass and ligation of PSA has been performed independently in the absence of any symptoms, foreseeing a possible complication in certain patients. [2,11,25] Those patients with stenosis in PSA can be treated with angioplasty. [2,11] Also, bypass was performed in patients with total occlusion in PSA, while PSA was ligated in patients having a risk for distal embolization.…”

“…[2,11,25] Those patients with stenosis in PSA can be treated with angioplasty. [2,11] Also, bypass was performed in patients with total occlusion in PSA, while PSA was ligated in patients having a risk for distal embolization. [27] A chemical anticoagulant therapy may be appropriate to save distal embolization in some patients with PSA.…”