PERSISTENT SCIATIC ARTERY ANEURYSM WITH RUPTURED INTERNAL ILIAC ARTERY ANEURYSM

A case of aneurysm of persistent sciatic artery with ruptured aneurysm of the internal iliac artery is reported. A 62-year-old man was admit ted to our hospital in emergency because of abdominal severe pain. Abd ominal CT and angiography showed aneurysm of the infrarenal aortic aor ta and left internal iliac artery and left persistent sciatic artery. The persistent sciatic artery aneurysm was coursed down the left thigh . Left superficial femoral artery was supplying blood to the popliteal artery as normal connection. Emergency operation was performed. The l eft internal iliac aneurysm was ruptured to a retroperitoneal space. T he aneurysm was replaced by a Y-shaped dacron double velour graft from the infrarenal abdominal aorta to right common iliac and left externa l iliac arteries, which was followed by a Ligation at the origin. of l eft persistent sciatic aneurysm. The pulsation of the left lower extre mity was good and additional bypass procedure to the popliteal artery was not performed. The post-operative course of the patient was excell ent and post-operative angiography showed. normal anatomy of the left lower extremity. Optimal management of ruptured abdominal aneurysm thu s requires not only an emergency operation but detailed observation of preoperative CT and. angiography in order to scrutinize the associate d vascular anomalies.