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October 17, 2008
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Michelle L DesChamplain*, Derek Brinster*
Virginia Commonwealth University-Medical College of Virginia, Richmond, VA
BACKGROUND: Persistent Sciatic Artery is a rare embryologic anomaly with an incidence of 0.025-0.04%. This aberrant artery is prone to atherosclerotic disease as well as aneurysmal degeneration. Although persistent sciatic artery aneurysms are reported in up to 46% of these patients, concominant AAA has not been addressed in the literature.
METHODS:
64 yo petite (5’0’’, 108lbs) AA female presents to her primary care physician with abdominal pain of several weeks duration. During the work-up of her abdominal pain, she is found to have an infrarenal abdominal aortic aneurysm. Over the subsequent 9 months, her intermittent abdominal and back pain continues and the abdominal aneurysm increases in size by 0.7cm. Pulse exam reveals 2+ femoral pulse on left with severely diminished femoral pulse on the right. On CT, the patient was noted to have an occluded right external iliac artery with a small caliber right femoral artery and 7mm persistent sciatic artery (PSA) supplying the right leg.
Evaluation of aortic measurements revealed that the infrarenal AAA was amenable to endovascular repair.
RESULTS:
An AneuRx AAAdvantage endograft was placed through the left common femoral artery. Deployment of the contra-lateral limb was undertaken through the right PSA by lateral thigh incision. One month follow-up CT shows endograft in good position without evidence of endoleak.
CONCLUSIONS: Although persistent sciatic artery aneurysm has been treated with endovascular repair, we believe that this is the first report of endovascular AAA repair using a persistent sciatic artery as access.
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Endovascular AAA Repair in patient with Persistent Sciatic Artery
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Michelle L DesChamplain*, Derek Brinster*
Virginia Commonwealth University-Medical College of Virginia, Richmond, VA
BACKGROUND: Persistent Sciatic Artery is a rare embryologic anomaly with an incidence of 0.025-0.04%. This aberrant artery is prone to atherosclerotic disease as well as aneurysmal degeneration. Although persistent sciatic artery aneurysms are reported in up to 46% of these patients, concominant AAA has not been addressed in the literature.
METHODS:
64 yo petite (5’0’’, 108lbs) AA female presents to her primary care physician with abdominal pain of several weeks duration. During the work-up of her abdominal pain, she is found to have an infrarenal abdominal aortic aneurysm. Over the subsequent 9 months, her intermittent abdominal and back pain continues and the abdominal aneurysm increases in size by 0.7cm. Pulse exam reveals 2+ femoral pulse on left with severely diminished femoral pulse on the right. On CT, the patient was noted to have an occluded right external iliac artery with a small caliber right femoral artery and 7mm persistent sciatic artery (PSA) supplying the right leg.
Evaluation of aortic measurements revealed that the infrarenal AAA was amenable to endovascular repair.
RESULTS:
An AneuRx AAAdvantage endograft was placed through the left common femoral artery. Deployment of the contra-lateral limb was undertaken through the right PSA by lateral thigh incision. One month follow-up CT shows endograft in good position without evidence of endoleak.
CONCLUSIONS: Although persistent sciatic artery aneurysm has been treated with endovascular repair, we believe that this is the first report of endovascular AAA repair using a persistent sciatic artery as access.
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