Introduction: Persistent sciatic artery (PSA) is a rare anomaly of high clinical significance. Embryological, part
of the sciatic artery involutes and other parts develop into the popliteal and peroneal arteries. Most cases present
silent with aneurysm formation. Treatment is aneurysm exclusion with maintaining limb vasculature.
Aim: Was to outline presentations and management PSA patients.
Patients: First was female with bilateral pulsating gluteal masses. A bypass was done between the internal iliac
and popliteal arteries because the femoral arteries were hypoplastic bilaterally. Second was 59y female presented
with critical left lower limb ischemia. Femoropopliteal bypass with exclusion of the aneurysm was done. Third
patient was 52y male with right painful pulsating gluteal mass with hypoplastic femorals.
Conclusions: PSA is a rare vascular anomaly. Treatment depends on clinical and angiography presentation. Usually
surgery is preferred. PSA awareness is in favor to appropriate management.