The persistent sciatic artery: Report of ten cases

Bilateral sciatic artery persistence in a patient with infrarenal abdominal aortic aneurysm

A persistent sciatic artery (PSA) is a rare congenital vascular anomaly, with an estimated prevalence ranging from 0.01% to 0.05%. This condition can cause ischemic events in the lower limbs and sciatic artery aneurysms but can also be asymptomatic. A PSA can complicate the treatment of other coexistent vascular diseases due to the thin caliber of the external iliac and femoral arteries. We report a case of a patient with bilateral PSAs and an infrarenal aortic aneurysm. The aneurysm was successfully treated by the endovascular approach. An ultra-low profile endograft associated with access incisions slightly above the usual position was used to overcome this challenging access.

Failure of Limb Salvage in a Patient with Chronic Limb-Threatening Ischemia due to Persistent Sciatic Artery Stenosis: Direct Therapeutic Intervention is Important

A 79-year-old woman presented to our hospital with a complaint of feeling a cold sensation in her right foot. After performing a contrast-enhanced computed tomography angiography, severe stenosis in the right persistent sciatic artery (PSA) was identified. However, stenting was considered inadvisable due to compression issues when sitting. Following anticoagulant therapy, the patient's symptoms improved. However, after seventeen months, she experienced recurrent severe pain in her right foot. Catheter angiography revealed occlusions in both the anterior and posterior tibial arteries. To address the issue, we conducted endovascular therapy, followed by a femoro-popliteal artery bypass and ligation of the PSA. Unfortunately, despite these efforts, a below-knee amputation was eventually performed. Limited experience with the PSA and delayed intervention may have led to the need for amputation. Therefore, it is crucial to emphasize the importance of prompt therapeutic intervention following the onset of initial symptoms.

An Interesting Case of a Patient With Disabling Bilateral Lower Extremity Claudication and a Persistent Sciatic Artery

A persistent sciatic artery is a rare congenital anomaly. This case report highlights the treatment for a patient with a persistent sciatic artery no longer in continuity with the internal iliac artery and atherosclerotic peripheral vascular disease resulting in disabling bilateral lower extremity claudication. It highlights the types and anatomic locations of the sciatic artery and discusses an effective way to treat a patient with arterial insufficiency and this variant anatomy as well as other treatment options.

Hybrid Repair of a Persistent Sciatic Artery Aneurysm

Persistent sciatic arteries are rare congenital abnormalities, with an incidence between .01-.6%. Whilst most patients with the pathology are asymptomatic during their younger years, up to 48% of patients will suffer aneurysmal degeneration of the persistent sciatic artery and present with claudication or lower limb ischaemia (from distal embolisation of mural thrombus). Due to the rare nature of persistent sciatic artery aneurysms, optimal management of the pathology is yet to be determined. Both endovascular and open techniques have been described in the management of this pathology, however hybrid management approaches are reported infrequently. The authors present a case of a persistent sciatic artery aneurysm successfully treated in a 69-year-old male utilising a hybrid approach with a femoropopliteal bypass (below knee), Amplatzer plug occlusion of the aneurysm and subsequent resection of the aneurysm.

An Infected Massive Persistent Sciatic Artery Aneurysm Treated by an Aneurysmal Incision and Drainage after Angiographic Embolization

A man in his 80s undergoing chronic hemodialysis presented with a high fever. A 10-cm soft mass was palpable in his right buttock. Abdominal computed tomography and angiography showed an incomplete-type unilateral persistent sciatic artery aneurysm (PSAA) with gas patterns and a blood flow through the aneurysm. Incision drainage was performed after arterial embolization. Gram staining of the hematoma showed gram-positive cocci that had formed chains, thus leading to a diagnosis of an infected PSAA. Drainage by incision after arterial embolization was used as the therapeutic method of choice for a massive infected PSAA with a sustained blood flow in order to prevent sciatic nerve injury and bleeding associated with PSAA resection.

Radiological and Embryological Relevance of Persistent Sciatic Arteries: A Rare Presentation

Persistent sciatic artery (PSA) is an extremely rare condition that is present in around 0.05% of the population and is commonly associated with many complications. The management is conservative or through surgical intervention and depends on the type of complication. The case presented is of a 40-year-old man who complained of persistent pain in the buttock region. On radiology, bilateral PSAs were observed exiting through the infra-pyriformis compartment of the greater sciatic foramen accompanying the sciatic nerve. The femoral artery and the external iliac artery are small in caliber. In this case report, we discuss the underlying embryology that might have led to the persistence of this vessel with illustrations and the abnormal radiological pattern of this anomaly. Increased awareness of PSA can improve patient care and prevent potentially hazardous complications during hip and renal transplant surgery.