Acute limb ischemia caused by a thrombosed persistent sciatic artery aneurysm: a case report

Persistent Sciatic Artery (PSA) is a rare vascular anomaly resulting from the sciatic artery´s failure to regress during embryonic development, leading to a continued primary blood supply to the lower limb. Persistent Sciatic Artery is associated with aneurysmal degeneration and thromboembolic complications, increasing the risk of acute limb ischemia. We present an 83-year-old woman with acute left limb ischemia due to a thrombosed PSA aneurysm (PSAA). Computed tomography (CT) imaging revealed a type 2a PSA with a 61 mm thrombosed aneurysm extending to the popliteal artery. Emergency femoro-popliteal bypass with a Dacron graft and thrombectomy restored circulation. Postoperative recovery was uneventful, with a patent bypass at nine weeks. This case highlights PSA management challenges, emphasizing timely surgical intervention. Given PSA´s rarity, further research and long-term follow-up are crucial for optimizing treatment strategies and outcomes in this potentially life-threatening condition.