Persistent Sciatic Artery Aneurysm Research Articles

A Hybrid Approach in the Treatment of Persistent Sciatic Artery Aneurysms

A Hybrid Approach in the Treatment of Persistent Sciatic Artery Aneurysms

Treatment Strategy for Persistent Sciatic Artery and Novel Classification Reflecting Anatomic Status

Persistent sciatic artery (PSA) is a relatively rare congenital variant of the lower limb vasculature and can have highly variable clinical presentations. The purpose of this study was to analyze the relationship between PSA anatomy and clinical presentation, and to suggest an optimal management strategy. Between 2001 and 2014, 24 PSAs in 19 patients were diagnosed by computed tomography and referred to the vascular surgery department. Patient demographics, types of PSA and femoral artery, aneurysmal changes, symptoms, and treatment methods were assessed. Additionally, all English literature from 1964 to 2014 was reviewed and compared using the PubMed database (224 PSAs in 171 patients). PSA was diagnosed in 10 men (52.6%) and nine women (47.4%). PSAs were bilateral in five patients (26.3%) and symptomatic in 12 patients, while in seven patients PSA was found incidentally. According to the Pillet-Gauffre classification, Type 2a was the most common variant (n=15/24, 62.5%), with unclassifiable types in two limbs. Compared with cases in the literature, the PSA occlusion rate in this study was higher (n=10/24, 41.7% vs. n=54/224, 27.5%), but aneurysm incidence was higher in the literature cases (n=5/24, 20.8% vs. n=112/224; 50.7%). In this study, 16 limbs (66.6%) were treated conservatively, and six limbs were treated by open surgery, including four bypasses, one amputation, and one thrombo-embolectomy. Endovascular coil embolization was performed in one limb, and a hybrid procedure with stent graft was performed in one limb with PSA aneurysm. Based on the present series and the literature review, a new classification system and treatment option is proposed according to the anatomic status and the presence of aneurysm. According to the new classification, class III was the most common in both the present study (18/24; 75%) and the literature review, and the presence of aneurysm was the most important determinant of surgical treatment. The new classification system is simple and provides guidance for management. Limb anatomy of the femoral artery system and the presence of PSA aneurysm should be considered when selecting the optimal treatment. The risk of embolism from the presence of aneurysm is an important factor for treatment, and bypass surgery is mostly required in classes III and IV.

Effectiveness of Exclusion of a Persistent Sciatic Artery Aneurysm with an Amplatzer™ Plug

Persistent sciatic artery is a rare developmental anomaly. In its complete form, it provides the major arterial supply to the lower leg since the femoral system is hypoplastic. These unique arteries are prone to aneurysm formation and most commonly present with complications related to aneurysm formation, which can lead to limb loss. We encountered a 68-year-old man presenting with bilateral lower-extremity ischemia who was found to have bilateral persistent sciatic artery aneurysms. One aneurysm had already thrombosed, but the other was still patent. We treated this patient with a hybrid open and endovascular repair on the patent side. The aneurysm was excluded with an Amplatzer™ plug (St. Jude Medical, Inc., St. Paul, MN) followed by a femoropopliteal bypass with saphenous vein in situ to revascularize the lower leg. To our knowledge, this is only the second report of a persistent sciatic artery aneurysm successfully treated with Amplatzer plug occlusion.

Infectious Persistent Sciatic Artery Aneurysm caused by Acupuncture Treatment

Infectious Persistent Sciatic Artery Aneurysm caused by Acupuncture Treatment

Incidental finding of a persistent sciatic artery aneurysm

Normal 0 false false false EN-GB ZH-CN X-NONE A 78 year old Afro Caribbean male, presented via accident & emergency following a mechanical fall. Work-up investigations revealed an incidental 6.2 cm persistent sciatic artery aneurysm. 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.

Commentary: endovascular treatment of persistent sciatic artery aneurysm with the multilayer stent: is it a miraculous solution for all complex conditions?

Commentary: endovascular treatment of persistent sciatic artery aneurysm with the multilayer stent: is it a miraculous solution for all complex conditions?

Persistent Sciatic Artery Aneurysm with Lower Limb Ischemia

Persistent sciatic artery is a very rare clinical entity. Those of us who have not seen the lesion regard this as a condition which is described in the literature through less than 200 cases. We report, here, a case of a 60-year-old female who presented to the surgical outdoor with complaints of a pulsatile gluteal swelling associated with ischemic changes in the ipsilateral lower limb. On Doppler and CT angiographic analysis, the patient was determined as having persistent sciatic artery aneurysm which was then managed by a combined surgical and endovascular approach. Ours is probably the first such case to be reported from India. The objective of this case report is to highlight the relevant embryology, the pathognomonic presenting features, the diagnostic dilemma, management, and complications associated with a case of persistent sciatic artery (PSA).

A Successful Staged Hybrid Treatments by Surgical and Catheter Intervention in a Patient with Persistent Sciatic Artery Aneurysm Presenting with Acute Lowers Limb Ischemia

A Successful Staged Hybrid Treatments by Surgical and Catheter Intervention in a Patient with Persistent Sciatic Artery Aneurysm Presenting with Acute Lowers Limb Ischemia

Persistent sciatic artery aneurysm: A plea for attention and proposal for management

Persistent sciatic artery aneurysm: A plea for attention and proposal for management

Anévrisme de l’artère sciatique persistante. Une cause rare de masse fessière douloureuse

The persistent sciatic artery is a rare cause of painful buttock mass with L5-S1radicular signs. A 56-year-old man presents a right painful buttock mass with L5-S1radicular symptoms for 3years. The surgical exploration found a pulsatile vascular mass like a persistent sciatic artery aneurysm. This vascular pathology is a misunderstood embryogenesis anomaly. The treatment aims to avoid serious complications. This pathology must be known from plastic surgeon.

Rapid Development of Aneurysmal Formation After Successful Endovascular Treatment of Chronic Total Occlusion of a Persistent Sciatic Artery

Persistent sciatic artery (PSA) is a rare congenital anomaly that is frequently complicated by atherosclerotic changes, such as occlusion and aneurysmal formation. This report describes a case of a chronic total occlusion (CTO) of a unilateral, complete-type PSA in the right thigh of a 74-year-old woman that was treated successfully with endovascular angioplasty and stent placement. Within 3 months, however, a PSA aneurysm developed in the gluteal region. This aneurysm was repaired endovascularly through placement of a stent graft. To the authors' knowledge, rapid formation of a PSA aneurysm and successful endovascular treatment of both CTO of a PSA and of a PSA aneurysm have not been reported previously.

Thrombosed Infectous Aneurysm of the Left Persistent Sciatic Artery

Thrombosed Infectous Aneurysm of the Left Persistent Sciatic Artery

Hybrid Treatment for a Persistent Sciatic Artery Aneurysm with Buttock Pain and Intermittent Claudication

Hybrid Treatment for a Persistent Sciatic Artery Aneurysm with Buttock Pain and Intermittent Claudication

Coil Embolization of Persistent Sciatic Artery Pseudoaneurysm Presenting as Blue Toe Syndrome, a Rare Case

In this report, a case of blue toe syndrome related to persistent sciatic artery pseudoaneurysm in a 63-year-old woman, which was diagnosed by selective angiography, is presented. The pseudoaneurysm was successfully treated with coil embolization with good clinical results. A persistent sciatic artery is a rare embryological anomaly that occurs when the sciatic artery fails to regress during fetal development. Therefore, thromboembolisms from persistent sciatic artery aneurysm are rare.

Persistent sciatic artery aneurysm with limb-threatening ischemia

A 50 year old lady with bilateral persistent sciatic artery aneurysm presented with severe limb ischemia due to distal embolization from a thrombus filled persistent sciatic artery aneurysm on one side. Persistent sciatic artery is a rare embryological anomaly which results due to the failure of development of the femoral system. Its complete variant can be clinically recognised by the presence of a weak femoral pulse with a normal popliteal pulse. The diagnostic and treatment considerations of this rare anomaly are described.

A case of bilateral persistent sciatic artery with unilateral aneurysm: An 18-year period of graft patency after excision of aneurysm

SummaryBackgroundA persistent sciatic artery (PSA) is a rare vascular anomaly with an estimated incidence of 0.02–0.04% and with a high rate of complications such as aneurysm formation, thromboembolism, and ischemia, that may lead to amputation.Case ReportWe present a case of a female patient with complete symptomatic ambilateral PSA and with unilateral aneurysm. The aneurysm was excised and the PTFE graft was interposed at the aneurismal sac (femoro-popliteal bypass could not be performed because of the high degree hypoplasia of the superficial femoral artery). The graft endured continuous compression and stretching during regular daily life of the patient. At check-up 18 years after the operation, the Doppler ultrasound showed a patent graft and no new aneurismal dilatation of the sciatic artery.ConclusionsTo our knowledge the follow-up of the presented case is the longest reported so far in the literature. The uneventful course of the patient confirms that classical aneurysmectomy still constitutes one of the treatment options of PSA aneurysm.

Intermediate and Long-Term Outcomes After Treating Symptomatic Persistent Sciatic Artery Using Different Techniques

Persistent sciatic artery (PSA) is a rare congenital vascular malformation. In this article, we have described the case of a 66-year-old woman presenting with a pulsatile mass in the left buttock and bilateral lower limb ischemia, who underwent surgical therapy. Preoperative computed tomography scanning showed a left thrombosed PSA aneurysm (PSAA) with concomitant occlusion of bilateral iliac, bilateral common femoral, and left popliteal arteries. After recanalization of the left common femoral artery occlusion with a systemic heparin treatment, the patient underwent bypass surgery (left femoropopliteal bypass, right iliofemoral bypass) and PSAA exclusion. Postoperative computed tomography scanning 20 months after surgery revealed that the excluded PSAA was thrombosed with no refilling collateral flow, and that the bypass grafts were patent in both legs. In addition to this case report, a literature review of PubMed articles published between 1965 and 2009 that included the treatment and intermediate/long-term management of symptomatic PSAs was conducted. We found 45 articles (67 limbs), of which 24 (29 limbs) described the intermediate/long-term outcomes in patients treated for symptomatic PSA. Regardless of the method of arterial reconstruction or PSAA repair, intermediate/long-term outcomes of different treatments for lower limb ischemia and PSAAs were satisfactory, and the patients were asymptomatic during the follow-up period which ranged from 2 months to 10 years.

Clinical management of lower limb ischemia secondary to a persistent sciatic artery aneurysm: Report of a case

A persistent sciatic artery (PSA) is a rare congenital malformation, frequently complicated by atherosclerotic changes such as aneurysmal formation. Optimal treatment is dependent on the individual situation. We report a case of a PSA aneurysm complicated by lower limb ischemia. Graft interposition with distal balloon angioplasty and thrombectomy from the posterior transgluteal approach was performed successfully, without any complications.

The Management of Persistent Sciatic Artery Aneurysm with Lower Extremity Ischemia: A Case Report

We report a case of lower extremity ischemia caused by a persistent sciatic artery aneurysm . The patient was successfully treated with a ringed expanded polytetrafluoroethylene (ePTFE) graft and recovered uneventfully. The graft was patent during the follow-up and no signs of kinking or restenosis.

A Combined Open and Endovascular Approach to Treat a Persistent Sciatic Artery Aneurysm in an Obese Patient

Persistent sciatic artery is a relatively uncommon peripheral vascular malformation of the lower extremity arterial blood supply that is often misdiagnosed. We present a case report of a 52-year-old, obese female who presented to our center with symptoms of lower extremity ischemia. We describe a novel approach combining open and endovascular techniques for the treatment of a persistent sciatic artery aneurysm, providing maximal benefit, while minimizing potential complications due to her co-morbidities.