Case report: Hybrid approach in the management of a complete persistent sciatic artery aneurysm

INTRODUCTION: Persistent sciatic artery (PSA) is a rare embryological vascular anomaly with a prevalence between 0.025–0.06%. PSA is frequently associated with aneurysmal degeneration and can result in neuropathy, thrombosis, or rupture, threatening limb and life. CASE PRESENTATION: We present a case of a 72-year-old man with an incidental finding of a right sided 4 cm PSA aneurysm with limited symptoms. The aneurysm was treated successfully with endovascular exclusion and a femoral-popliteal bypass was performed to revascularize the leg. DISCUSSION: Treatment of PSA aneurysms involve excluding the aneurysm and revascularizing the involved leg. Improvements in endovascular embolization techniques now offer new solutions in the management of these aneurysms. CONCLUSION: A high degree of clinical suspicion is required to properly diagnose and treat PSA aneurysms. Referral to a center with expertise in both open and endovascular techniques is vital to ensure good outcomes.