A Case of Abdominal Aortic and Left Internal Iliac Aneurysms in a Patient with a Left Persistent Sciatic Artery That Had to be Preserved Using an Iliac Branch System

Abstract

We report a rare case of left persistent sciatic artery (LPSA) in a patient with an abdominal aortic aneurysm (AAA) and a left internal iliac aneurysm (LIIA). The AAA and LIIA were first identified on computed tomography (CT) after orthopedic surgery in a 74-year-old man. The LPSA had to be preserved because it provided the major blood supply to the lower limbs. Endovascular aortic repair (EVAR) with an iliac branch system (Gore Excluder iliac branch endoprosthesis [IBE]) was performed to preserve the LPSA and repair the aneurysm. We performed a coil embolization before placement of the IBE because branches from the internal iliac aneurysm can cause type II endoleak. The surgical procedure was completed without any complications, and no endoleak was observed on the final angiography. Postoperative CT revealed optimal flow in the LPSA after 1 year 6 months, and no aneurysm or thrombosis was observed. Placement of an IBE can be effective for preserving LPSA.