A symptomatic persistent sciatic artery aneurysm treated with a hybrid technique

Persistent sciatic artery (PSA) is a rare congenital vascular anomaly, characterized by failure of the sciatic artery to regress in the embryonic stage of development. The symptoms occur in case of compression of the sciatic nerve or distal embolization and acute ischemia secondary to thrombosis of the aneurysmatic evolution of PSA. This study presents the case of an important PSA aneurysm with clinical evidence (such as leg pain), undergoing hybrid treatment for a right PSA aneurysm through femoropopliteal bypass and embolization of the aneurysm with vascular plugs. Our treatment of choice was to avoid using coils in the aneurysmatic sac, in order to permit a better sac shrinkage and reduction of sciatic nerve compression. The follow-up protocol consisted in one angio-TC at one-month control visit and then the Duplex scan exam. During follow-up we noticed a complete exclusion of PSA aneurysm with significant diameter reduction, so the choice of a hybrid treatment was useful to improve neurological symptoms as pain, thanks to an important sac shrinkage of PSA aneurysm. In conclusion, hybrid treatment is an effective choice for patients with PSA aneurysm.