Transposition of the persistent sciatic artery for lower limb revascularization after resection of an embolizing proximal sciatic artery aneurysm

We present a novel surgical technique for lower limb revascularization after resection of an aneurysm of the persistent sciatic artery that had led to recurrent peripheral embolization and severe ischemia. The superficial femoral artery in this patient was hypoplastic, and the sciatic artery continued into the popliteal artery as the source of blood supply to the lower leg. For revascularization, we used the distally pedicled healthy two-thirds of the persistent sciatic artery, transposed it from its posterior position to a nearly anatomic anteromedial position, and anastomosed it to the proximal superficial femoral artery.