Abstract
Persistent sciatic artery (PSA) aneurysms are rare vascular anomalies that can lead to significant clinical complications. This case report details the diagnosis, initial management, and long-term follow-up of a 66-year-old female patient who presented with progressive right gluteal pain. Diagnostic imaging at the initial hospital visit identified a 6.5 cm saccular aneurysm in the right sciatic artery. The patient underwent endovascular repair using a Vascutek Anaconda stent graft limb (Terumo, Florida, USA) via a femoral access. Four years later, a recurrence of the aneurysm was detected at the distal end of the stent graft, measuring 3.5 cm. Endovascular treatment, including stent extension, was successfully performed. The patient was discharged in stable condition with a recommendation for 6-month follow-up imaging. This case underscores the importance of advanced imaging for accurate diagnosis and the efficacy of endovascular techniques in managing PSA aneurysms. The recurrence highlights the need for ongoing surveillance and tailored interventions. This case contributes to the limited literature on PSA aneurysms and offers insights into effective management strategies. It emphasizes that persistent sciatic artery aneurysms require a multidisciplinary approach and careful long-term follow-up, with endovascular techniques, combined with cross-sectional imaging, providing effective management that improves patient outcomes.