2018 Volume 27 Issue 2 Pages 69-72
A 73-year-old woman complained of muscle weakness and numbness of the left hip and thigh. Non-pulsatile mass in the left thigh, muscle weakness, and sensory disorder in the left lower thigh were observed. There were no symptoms of lower-limb ischemia. Contrast enhanced CT angiography revealed a thrombosed persistent sciatic artery aneurysm which was 60 mm in diameter, a hypoplastic superficial femoral artery, and collateral circulation from deep femoral artery to popliteal artery. She was diagnosed as sciatic nerve neuropathy caused by compression of thrombosed persistent sciatic artery aneurysm. Complete resection of the aneurysm was impossible due to the strong adhesion of tibial and peroneal nerve to the aneurysm, therefore, thrombectomy and partial resection of the aneurysm without a bypass procedure were performed. Lower extremity neuropathy was improved and no symptoms of lower-limb ischemia were observed postoperatively. She was discharged on postoperative day 18. The symptoms with the persistent sciatic artery aneurysm are divided into lower limb ischemia and the sciatic nerve compression. Revascularization is required for the treatment of lower limb ischemia, and resection or mass reduction is required for the treatment of the sciatic nerve compression. Preoperative evaluation of blood flow and neuropathy is essential for the choice of the operation.
