Endovascular Repair of a Persistent Sciatic Artery Aneurysm

Christos Verikokos; Efthimios D. Avgerinos; Achilleas Chatziioannou; Athanasios Katsargyris; Chris Klonaris

Disclosures

Vascular. 2010;18(3) 

In This Article

Abstract and Introduction

Abstract

Persistent sciatic artery (PSA), a persistent embryologic continuation of the internal iliac artery, represents a rare yet clinically important vascular anomaly. PSA is prone to aneurysmal change, which can subsequently lead to distal embolization, sciatic neuropathy, or rupture. The conventional surgical treatment of PSA aneurysms is commonly complex and carries the risk for sciatic nerve damage. We report herein the successful endovascular management of a PSA aneurysm and postaneurysmal stenosis with the use of two overlapping self-expanding stent-grafts via a contralateral transfemoral approach. Additionally, a review of the literature regarding the treatment of these unusual peripheral aneurysms is provided.

Introduction

Green first reported in 1832 the presence of a persistent sciatic artery (PSA)-a remnant of the earliest axial artery of the lower extremity in the human embryo-in a postmortem case.[1] In the modern literature, few cases of PSAs have been described with variable pathology.[2,3] The PSA has been said to be prone to early atherosclerotic degeneration and particularly aneurysm formation.[2] Ligation, bypass, coil occlusion, aneurysmorrhaphy, and thrombolysis have all been reported as treatment alternatives, despite being questionable owing to technical complexity and moderate outcomes.[2] Currently, there are limited case reports confirming the feasibility and short-term effectiveness of stenting PSA aneurysms.[3–7] As experience is still poor, we add to the current literature a case of endovascular management of combined aneurysmal and stenotic lesions of a PSA.

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