Incidental finding of a persistent sciatic artery aneurysm
Abstract
Following discussion with the vascular surgeons, lower limb angiography and a lower limb arterial duplex were performed. This demonstrated the true morphology of the persistent sciatic artery where it was shown to be the dominant blood supply to the leg; the superficial femoral artery in comparison was small and petered distally.
Treatment options were considered including embolization of the aneurysm and endovascular repair with a covered stent. Both options were considered too high risk for compromising the blood supply to the entire leg and the patient was managed conservatively.
A persistent sciatic artery (PSA) is a congenital anomaly, with an incidence estimated to be in the region of 0.03%-0.06%. 5 Persistence of the embryological sciatic artery is rare and any patient with a PSA must be managed uniquely and in a considered manner. This case demonstrates the clinical significance of this anatomical variation and the potential pitfalls of treatment without adequate imaging of the lower limb. Patients with a patent sciatic artery are more prone to atherosclerotic degeneration and aneurysm formation, and this occurs in up to 44% [1]. Lack of recognition that the main blood supply to the lower leg is from a PSA may lead to inappropriate bypass grafting for what appears otherwise to be an occluded superficial femoral artery.
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PDFDOI: https://doi.org/10.5430/crim.v2n1p92
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Case Reports in Internal Medicine
ISSN 2332-7243(Print) ISSN 2332-7251(Online)
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