Elsevier

Annals of Vascular Surgery

Volume 23, Issue 3, May–June 2009, Pages 411.e1-411.e4
Annals of Vascular Surgery

Case Report
Coil Embolization of Symptomatic Persistent Sciatic Artery Aneurysm: A Case Report

https://doi.org/10.1016/j.avsg.2008.05.006Get rights and content

Persistent sciatic artery is a rare congenital vascular anomaly of the lower extremity. This artery is predisposed to atherosclerosis or aneurysm formation. Persistent sciatic artery aneurysm often causes limb-threatening ischemia owing to its thrombosis or its mural thrombus. We report a case of successful transcatheter coil embolization for persistent sciatic artery aneurysm. An 89-year-old woman presented to our hospital, suffering from severe ischemia of the right leg and a pulsatile mass in the right buttock. Angiography and enhanced computed tomography revealed right persistent sciatic artery aneurysm with mural thrombus and complete occlusion of the distal end. After she underwent major amputation because of the advanced ischemia following unsuccessful thrombectomy, we performed coil embolization for the aneurysm successfully. Endovascular treatment including transcatheter embolization for persistent sciatic artery aneurysm is safe, effective, and less invasive than surgery. Its application gives various therapeutic options for the treatment of persistent sciatic artery aneurysm.

Section snippets

Case Report

An 89-year-old woman presented to our hospital, complaining of severe rest pain, coldness, and numbness in the right lower extremity with sharp onset 3 days previously. She had recognized intermittent claudication before. Her past history was unremarkable for risk factors of atherosclerosis. Physical examination showed cyanosis in the right lower extremity without apparent tissue necrosis. The right femoral and popliteal pulses were palpable. The pulses below the knee were absent and not

Discussion

In the early embryo, the axial artery is the major vascular supply to the lower extremity.7, 8 In normal development, the axial artery involutes. The femoral artery system develops further and takes the place of the axial artery after the 22 mm embryological stage. The remnants of the axial artery are normally found in the adult as the inferior gluteal artery, the ramus concomitans of the sciatic nerve, the perforating arteries of the deep femoral system, and parts of the popliteal and peroneal

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