Kauvery Hospital Chennai, a unit of Kauvery Group of Hospitals in Tamil Nadu, on Tuesday, November 8 announced the successful treatment of a 60-year-old man with a rare vascular anomaly- aneurysm of persistent sciatic artery. This sciatic artery arises from the foetal aorta and runs on the back side of the buttock and lower limb and is the main blood supply to the leg. It disappears soon after development of the femoral artery, which is the new permanent artery that carries blood to the leg in later life. The sciatic artery does not persist in adults. When it is present, it is prone for complications because during sitting, the artery gets compressed and damaged resulting in ballooning (aneurysm) and clots.

A 60-year-old man visited the Department of Vascular and Endovascular Surgery at Kauvery Hospital with severe pain, a pulsation in the right buttock and blackish discolouration of the right big toe. He also faced difficulty in sitting or walking for a long time due to pain in his buttock. On examination, he was found to have a pulsating swelling in his right buttock, and a gangrene of the right big toe.

Dr N Sekar, HOD & Chief Vascular & Endovascular Surgeon, Kauvery Hospital said, “An angiogram was done, which showed a large aneurysm, with a clot, in a persistent sciatic artery. The femoral artery was absent in the thigh. The sciatic artery was seen going all the way down to the knee and joining the arteries in the leg.

A hybrid procedure was performed on the man, maintaining the blood circulation in his limb. The procedure involved femoro popliteal bypass surgery (femoral popliteal bypass surgery, or fem pop bypass, creates a new route for blood flow to your lower leg) and blocking the anomalous artery and aneurysm by using a vascular plug. He gradually recovered and was relieved of his pain. His toe was also saved from amputation.”

Speaking on the condition, Dr Aravindan Selvaraj, Co-Founder & Executive Director, Kauvery hospital Chennai said, “Persistent Sciatic Artery is a rare congenital vascular anomaly which occurs among one in 1 lakh of the population. It is rarely symptomatic, and when symptomatic, difficult to diagnose. Complications can occur including aneurysm formation (which occurs when an artery’s wall weakens and results in an abnormally large bulge) and ischemia (reduced blood flow) in legs. This can compromise the leg and even lead to amputation in severe cases. In this patient, the thrombus (clot) in the aneurysm had gone downstream and was the cause of the gangrene of the toe.”