Endovascular Abdominal Aortic Aneurysm Repair Through a Persistent Sciatic Artery

Conventional access for endovascular infrarenal aortic aneurysm repair is through the femoral artery. In rare circumstances, an anomalous persistent sciatic artery may replace the femoral arterial system as the main blood supply of the lower extremity. We report the case of a 64-year-old woman with a rapidly expanding infrarenal abdominal aortic aneurysm. Preoperative computed tomography revealed a right persistent sciatic artery with an ipsilateral atrophic femoral artery. Her aortic aneurysm was successfully repaired using an endovascular approach with access through the right persistent sciatic artery and contralateral femoral artery. A persistent sciatic artery can be used as an access for endovascular treatment of an infrarenal aortic aneurysm. This technique can be extrapolated to the treatment of distal or contralateral aneurysms, precluding the need for open operation.