CTICasesPersistent Sciatic Artery with Infected Pseudoaneurysm
Imaging findings
CT showed a diminutive left superficial femoral artery arising from a dominant profunda femoris, with a separate large vessel coursing posteriorly through the sciatic notch and continuing distally to become the popliteal artery, consistent with a persistent sciatic artery. The patient presented with gluteal pain and fever, and this anomalous vessel had developed an infected pseudoaneurysm, treated with antibiotics and surgical grafting.
Key takeaways
Persistent sciatic artery is a rare (roughly 0.03% incidence) congenital lower-extremity arterial variant in which the artery courses through the sciatic notch to become the popliteal artery rather than following the normal femoral/superficial femoral course, classically tested for by the finding of a palpable distal pulse (e.g., dorsalis pedis) despite an absent or diminished femoral pulse; the anomalous vessel is prone to aneurysm formation and, as in this case, can become infected and present as a pseudoaneurysm requiring surgical repair, and its course is important to recognize during pelvic interventional planning.
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