Case report: persistent bilateral complete sciatic artery associated with aneurysmal degeneration

Introduction: Persistence of the ischial artery is a rare congenital anomaly that has few cases described in the literature. Objectives: To present the embryological variation observed in the circulatory system of both lower limbs in this patient, and its epidemiology, diagnosis, classification and treatment. Methods: Description of the anatomical variation based on review of electronic medical records and radiology exams. Results: A 63-year-old female patient was admitted to the emergency department complaining of severe pain in the right lower limb, with ecchymosis on the dorsum of the foot and cold extremity. Physical examination showed absence of pedicle, posterior tibial, popliteal and femoral pulse. Arterial Doppler was performed and showed no detectable flow in the anterior tibial and fibular arteries due to thromboembolic phenomenon. The patient was referred for emergency thromboembolectomy, however, after the procedure, adequate reperfusion was not visualized. After three days, the patient presented a limb with necrosis and was submitted to transfemoral amputation. Conclusion: Despite being a rare condition, it has great clinical importance due to the high complication rates. Even with many techniques described, there is still no consensus on the best treatment.