Persistent Sciatic Artery Aneurysm: A Rare Cause of Subacute Lower Limb Ischemia in Department « B » of Surgery of the Teaching Hospital Point « G » Bamako

The persistent sciatic artery is a rare congenital anomaly. Its clinical presentation may be related to an aneurysmal degeneration witch complications such as sciatic compression with neuralgia, thrombosis or distal embolization. A 56-year- old tailor was referred to our department for a painful right gluteal mass radiating to the posterior aspect of the thigh and ankle that was considered as sciatic L5-S1. Three weeks before his admission, limb edema with a cyanotic aspect of the foot was associated with the clinical signs. An ultrasound duplex revealed an aneurysm of the Superior gluteal artery. The CT angiography concluded an aberrant aneurysmal sciatic artery mean vascularized the limb. Revascularization surgery by saphenous vein femoro-popliteal bypass associated with aneurysmal resection was performed in a timely. With a follow of 4 years, the patient is well. Ultrasound duplex and CT angiography control shows perfect suppression of the aneurysm with vascular patency of the limb. The rarity, the diagnostic and therapeutic difficulties motivated this case report.