Abstract
Persistent sciatic artery (PSA) aneurysms occur infrequently and present a diagnostic and therapeutic challenge. The PSA is often associated with a hypoplastic femoral system meaning revascularisation is necessary in addition to exclusion of the aneurysm. We present a case of a PSA aneurysm presenting with symptoms of sciatic nerve compression, successfully treated with exclusion and revascularisation with an obturator bypass. Obturator bypass of a PSA aneurysm has been reported once, in that case to treat distal ischaemic symptoms. The aetiology, presentation and management of PSA aneurysms are discussed, concluding that obturator bypass is a satisfactory option for PSA aneursym associated with a hypoplastic femoral system.