A persistent sciatic artery is a rare congenital anomaly. This case report highlights the treatment for a patient with a persistent sciatic artery no longer in continuity with the internal iliac artery and atherosclerotic peripheral vascular disease resulting in disabling bilateral lower extremity claudication. It highlights the types and anatomic locations of the sciatic artery and discusses an effective way to treat a patient with arterial insufficiency and this variant anatomy as well as other treatment options.
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