ANEURYSM OF BILATERAL PERSISTENT SCIATIC ARTERIES WITH ISCHEMIC COMPLICATIONS - CASE-REPORT AND REVIEW OF THE WORLD LITERATURE

A case of bilateral persistent sciatic artery (PSA) aneurysms with thr omboembolic complications is presented along with a review of the 167 cases of PSA reported in the world literature. Its embryology, anatomy , clinical features, diagnosis, and treatment are reviewed and provide the following findings: The incidence of PSA is estimated to be from 0.025% to 0.04%, based on angiographic studies. Ages range from 6 mont hs to 89 years, with a mean of 54 years. There is no gender predilecti on. A PSA was present on the right side in 32%, on the left side in 29 %, bilaterally in 22%, and on either side in 18%. The ''complete'' typ e of PSA was 69%. Aneurysmal change was present in 46% of all PSAs. Ov erall, 59% had symptoms, including ischemia in 31% (acute in 14% and c hronic in 17%), a gluteal mass in 26% (painful in 10%, painless in 6%, and pulsatile in 13%), gluteal pain in 2%, and ischialgia in 5%. Excl usion of the aneurysm or PSA by surgical or interventional techniques, with a femorodistal bypass as required for the resultant ischemia is currently the treatment of choice.