Bilateral Persistent Sciatic Artery With Unilateral Thrombosis: A Rare Case of Acute Limb Ischemia Successfully Managed With Endovascular Intervention

A persistent sciatic artery is a rare congenital vascular anomaly resulting from the failed regression of the sciatic artery during fetal development. It is associated with complications such as thrombosis, aneurysm formation, and acute limb ischemia. A 49-year-old female presented with acute limb ischemia of the left lower limb. Computed tomography angiography confirmed bilateral persistent sciatic arteries with thrombosis affecting only the left limb. She underwent successful endovascular balloon angioplasty and percutaneous thrombectomy, resulting in symptom resolution. Acute limb ischemia is the second most common presentation of persistent sciatic artery, occurring in 33.3% of cases. While computed tomography angiography is the gold standard for diagnosis, magnetic resonance angiography has been used in select cases. Management includes conservative treatment, endovascular intervention, or surgical repair. A bilateral persistent sciatic artery with unilateral thrombosis is rare. Early diagnosis and appropriate intervention, such as endovascular therapy, are essential to prevent complications. Long-term vascular surveillance is crucial for optimal patient outcomes.