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Background: Persistent Sciatic Artery (PSA) is a rare congenital arterial disease. Patients presenting this condition carry a high risk of acute limb ischemia and ensuing risk of lower limb loss. Although several treatment options have been described and published, a mutual consensus concerning optimal management has not yet been established. Case presentation: Two distinguished cases of successful hybrid repair of the left PSA in a 50-year-old man and an 89-year old woman at our institution are reported herein. Both patients presented in the emergency department with a two-day history of severe left leg pain and subsequently underwent hybrid treatment of PSA with embolization and femoro-popliteal bypass. A review of the literature has since been carried out on this specific topic in order to support our choice of treatment. Conclusions: The hybrid approach is a feasible and reliable treatment strategy for patients with PSA.

A 67-year-old man with pain in his right flank and hematuria over the last few weeks was admitted to our hospital due to right renal calculi revealed by an ultrasound examination of the urinary tract. An abdominal x-ray drew attention to the presence of structures of an uncertain interpretation, that mimicked multiple calculi in the right kidney and renal pelvis, but CT-scan identified a large saccular aneurysm of 76 mm with renal pelvis involvement and urinary statis of the right renal artery. A combined endovascular and laparoscopic surgical approach was chosen. The patient underwent endovascular embolization of the renal artery with an Amplatzer Vascular Plug followed by a video laparoscopic nephrectomy. After few days of hospitalization, the patient was in good general status and was discharged. A review of the literature has highlighted the unicity of our surgical approach, especially within the context of traditional vascular and general surgical practice, due to multidisciplinary consultation.

Extracranial carotid artery aneurysms (ECAAs) are not a common occurrence. As a result, its natural clinical course and the risk factors associated with an adverse outcome are largely unknown. Herein, we describe the endovascular treatment of two extracranial carotid artery aneurysms with flow diverter stents. Flow-diverter devices are stents placed in the parent artery at the level of the neck aneurysm in order to disrupt the intra-aneurysmal flow, thereby favoring intra-aneurysmal thrombosis. In the first case, an angio-CT scan was performed at one-month follow-up and in the second case a duplex scan was performed after four months. Both cases resulted in good stent positioning with complete exclusion of the aneurysm and complete carotid artery patency. Based upon our own clinical experience, endovascular treatment with flow diverter stents merit to be recognized and considered an option in cases of ECAA acknowledging that larger studies or larger series are needed to concur experience.