PMC7718314_01
Computed tomography (CT) reconstructions demonstrating a right-sided persistent sciatic artery aneurysm. A) The right PSA is a continuation of the internal iliac artery and exits the pelvis caudally. B) The right PSA courses inferiorly along the entire right thigh. C) Continuation of right PSA as a popliteal artery. Note the hypoplastic nature of the distal right superficial femoral artery.
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Follow-up CT angiography confirmed the diagnosis of a right sided persistent sciatic artery aneurysm and also demonstrated a hypoplastic right superficial femoral artery (SFA). (Fig. 1).
A) Computed tomography (CT) axial images at the gluteal region demonstrating a right-sided persistent sciatic artery (PSA) aneurysm. B) Coronal view of the posterior thigh elucidating the path of the right PSA from iliac artery to popliteal artery. C) Sagittal view confirming the size and location of the right PSA aneurysm.
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Maximal aneurysm dimensions were 40 mm x 35 mm in the right gluteal region (Fig. 2).
Intra-operative angiography scan prior to persistent sciatic artery (PSA) aneurysm embolization and femoropopliteal bypass. A, B, D) Angiography demonstrating a complete type PSA along with a hypoplastic superficial femoral artery (C).
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After a standard pre-operative evaluation, the patient elected to proceed with surgery to reduce the potential risk of aneurysm rupture, thrombosis or embolization (Fig. 3).
Intra-operative angiography following persistent sciatic artery (PSA) aneurysm embolization and femoropopliteal bypass. A, C) Completion angiography of the proximal superficial femoral to below knee popliteal artery saphenous vein bypass. B) Proximal and distal embolization of the PSA aneurysm. D) Completion angiography demonstrating single vessel runoff via a patent right posterior tibial artery.
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Ipsilateral saphenous vein was harvested and a non-reversed proximal superficial femoral to below knee popliteal artery bypass was performed to restore perfusion to the patients right lower extremity (Fig. 4).