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

A 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. We 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. To 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.