The Management of Persistent Sciatic Artery Aneurysm with Lower Extremity Ischemia: A Case Report

Chen, Bin; Shi, Zhenyu; Wang, Yuqi; Fu, Weiguo; Li, Weimiao

doi:10.3400/avd.cr.11.00033

Cited by 3 publications

(2 citation statements)

References 8 publications

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“… 6 ) Treatment of a PSA aneurysm, requires surgical or endovascular resection and exclusion by coiling or the placement of a stent-graft. 7 – 10 )…”

Section: Discussionmentioning

confidence: 99%

Persistent Sciatic Artery Aneurysm with Limb Ischemia: A Report of Two Cases

Morisaki

Yamaoka

Iwasa

et al. 2017

Annals of Vascular Diseases

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“… 6 ) Treatment of a PSA aneurysm, requires surgical or endovascular resection and exclusion by coiling or the placement of a stent-graft. 7 – 10 )…”

Section: Discussionmentioning

confidence: 99%

Persistent Sciatic Artery Aneurysm with Limb Ischemia: A Report of Two Cases

Morisaki

Yamaoka

Iwasa

et al. 2017

Annals of Vascular Diseases

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“…A PSAA may exert mass effects on the sciatic nerve causing vague discomfort and lower limb numbness mimicking sciatica. [23][24][25] Furthermore, the presence of PSAA has been associated with a higher risk of intramural thrombus formation and eventually with a higher risk for distal embolization. 6 The differences in the vessel's diameter across the aneurysm alter the laminar blood flow, which has been associated with thrombus formation.…”

Section: Discussionmentioning

confidence: 99%

Endovascular Treatment of Persistent Sciatic Artery Aneurysms With Primary Stenting: A Systematic Review of the Literature

Charisis

Giannopoulos

Tzavellas

et al. 2020

Vasc Endovascular Surg

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Persistent sciatic artery (PSA) is an embryologic remnant of the internal iliac artery, and when is present, it undergoes aneurysmal degeneration in up to 60% of the cases. Endovascular repair is an increasingly utilized treatment strategy for PSA aneurysms (PSAAs). The objective was to demonstrate the safety and efficacy of the endovascular repair in patients with PSAA and to identify potential risk factors for loss of patency or limb loss. This systematic review was conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines, and eligible studies were identified through search of the PubMed, Scopus, and Cochrane Central databases. Fifteen case reports, comprising 15 patients overall, were included. The median age of the patients was 68 years old (mean age 66 ± 13.4 years) with half of the reported patients being women. Most patients presented with progressive limb claudication, complaining about an enlarging palpable pulsatile buttock mass. The onset of symptoms was sudden in 78% of the reported cases. Additionally, the distal pulses on PSAA side were diminished or absent in 91% of the patients. Acute limb ischemia was the primary diagnosis in 75% of the cases. All patients underwent endovascular repair of the PSAA with a covered stent. Procedural outcomes were favorable in all patients demonstrating no symptoms recurrence, aneurysmal regression, or total obliteration evaluated by angiographic studies (computed tomography angiography [CTA] and angiogram). Periprocedural imaging evaluation was determined either with CTA or duplex ultrasound (DUS). Periprocedural complications included only 1 endoleak with distal dissection. This endoleak was identified after stent deployment and dissection distal to the aneurysm. Mean follow-up (with CTA and/or DUS) was 22 months, with all patients being asymptomatic with no recurrence of symptom. The endovascular treatment of PSAA with covered stent is safe and effective. Persistent sciatic artery aneurysms is associated with high procedural success, low periprocedural compilations, and favorable mid-term follow-up.

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