Abstract
Persistent sciatic artery (PSA) is a rare congenital anomaly and often results in aneurysmal or occlusive changes. A 66-year-old woman was referred with complaints of left buttock pain with sciatic neuralgia and intermittent claudication of the left leg. The left ankle-brachial index was 0.7, and computed tomography (CT) and magnetic resonance (MR) angiographies showed a left PSA aneurysm with occlusion of the distal portion of the PSA. Surgery was performed in the right semi-lateral position. The internal iliac artery was exposed retroperitoneally, and the proximal portion of the PSA was ligated at the bottom of the pelvic cavity. Subsequent resection of the aneurysm was performed through the Moore posterior approach at the buttock. To restore the blood flow to the left lower extremity, the distal PSA was exposed through a posterior incision of the mid-thigh, and an obturator bypass was performed from the internal iliac artery to the distal PSA using a ringed 8-mm ePTFE graft. One year later, she has no leg claudication, buttock pain or sciatic neuralgia, and the graft is patent.
