Ruptured Persistent Sciatic Artery Aneurysm Managed by Endovascular Embolization

Combiz Rezayat, Elliot Sambol, Lee Goldstein, Stephen Broderick, John K. Karwowski, James F. McKinsey, Ageliki G. Vouyouka

Research output: Contribution to journalArticle

Abstract

Persistent sciatic artery (PSA) is a rare vascular anomaly present in 0.025% to 0.05% of the population. They are particularly prone to aneurysmal degeneration, potentially leading to distal ischemia, sciatic neuropathy, or rarely rupture. Here, we describe a case of a ruptured PSA aneurysm managed by endovascular embolization. A 70-year-old man initially presented with acute left lower extremity ischemia. He was found to have a popliteal embolus originating from a complete persistent sciatic artery aneurysm. He underwent thrombolysis followed by a femoropopliteal bypass and ligation of the proximal popliteal artery to exclude the PSA. Four weeks later he re-presented with severe pain, a pulsatile buttock mass, and anemia in the setting of hemodynamic instability. A ruptured PSA aneurysm was confirmed by computed tomography angiography (CTA). This was managed emergently by endovascular exclusion of the inflow and outflow vessels using Amplatzer vascular plugs. His postoperative course was complicated by both a foot drop, likely secondary to sciatic nerve ischemia, and a buttock abscess. To our knowledge, this is the first report detailing the endovascular management of a ruptured PSA aneurysm. The etiology, management, and complications associated with the treatment of this rare vascular entity are discussed.

Original languageEnglish (US)
JournalAnnals of Vascular Surgery
Volume24
Issue number1
DOIs
StatePublished - Jan 2010
Externally publishedYes

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Aneurysm
Arteries
Blood Vessels
Buttocks
Ischemia
Sciatic Neuropathy
Popliteal Artery
Sciatic Nerve
Embolism
Abscess
Ligation
Foot
Anemia
Rupture
Lower Extremity
Hemodynamics
Pain
Population

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine
  • Surgery

Cite this

Rezayat, C., Sambol, E., Goldstein, L., Broderick, S., Karwowski, J. K., McKinsey, J. F., & Vouyouka, A. G. (2010). Ruptured Persistent Sciatic Artery Aneurysm Managed by Endovascular Embolization. Annals of Vascular Surgery, 24(1). https://doi.org/10.1016/j.avsg.2009.07.003

Ruptured Persistent Sciatic Artery Aneurysm Managed by Endovascular Embolization. / Rezayat, Combiz; Sambol, Elliot; Goldstein, Lee; Broderick, Stephen; Karwowski, John K.; McKinsey, James F.; Vouyouka, Ageliki G.

In: Annals of Vascular Surgery, Vol. 24, No. 1, 01.2010.

Research output: Contribution to journalArticle

Rezayat, C, Sambol, E, Goldstein, L, Broderick, S, Karwowski, JK, McKinsey, JF & Vouyouka, AG 2010, 'Ruptured Persistent Sciatic Artery Aneurysm Managed by Endovascular Embolization', Annals of Vascular Surgery, vol. 24, no. 1. https://doi.org/10.1016/j.avsg.2009.07.003
Rezayat, Combiz ; Sambol, Elliot ; Goldstein, Lee ; Broderick, Stephen ; Karwowski, John K. ; McKinsey, James F. ; Vouyouka, Ageliki G. / Ruptured Persistent Sciatic Artery Aneurysm Managed by Endovascular Embolization. In: Annals of Vascular Surgery. 2010 ; Vol. 24, No. 1.
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