Reference : Fibromuscular dysplasia of the internal carotid artery. Personal experience with 13 c...
Scientific journals : Article
Human health sciences : Surgery
http://hdl.handle.net/2268/112450
Fibromuscular dysplasia of the internal carotid artery. Personal experience with 13 cases and literature review.
English
VAN DAMME, Hendrik mailto [Centre Hospitalier Universitaire de Liège - CHU > > Chirurgie cardio-vasculaire]
SakalihasanN, Natzi mailto [Centre Hospitalier Universitaire de Liège - CHU > > Chirurgie cardio-vasculaire]
Limet, Raymond mailto [Centre Hospitalier Universitaire de Liège - CHU > > Chirurgie cardio-vasculaire]
1999
Acta Chirurgica Belgica
Acta Medica Belgica
99
4
163-8
Yes (verified by ORBi)
International
0001-5458
Bruxelles
Belgique
[en] Aged ; Aneurysm/surgery ; Angioplasty, Balloon ; Aspirin/therapeutic use ; Blindness/etiology ; Brain Ischemia/etiology ; Carotid Artery Diseases/diagnosis/drug therapy/surgery/therapy ; Carotid Artery, Internal/pathology/surgery ; Cerebral Angiography ; Endarterectomy, Carotid ; Female ; Fibromuscular Dysplasia/diagnosis/drug therapy/surgery/therapy ; Follow-Up Studies ; Humans ; Ischemic Attack, Transient/etiology ; Male ; Middle Aged ; Platelet Aggregation Inhibitors/therapeutic use ; Regional Blood Flow/physiology ; Stroke/etiology ; Thrombectomy
[en] From January 1990 to December 1997, the authors observed 13 cases of fibromuscular dysplasia of the internal carotid artery. Four patients presented transient ischemic attacks, one amaurosis fugax, two suffered from a minor stroke, four had non-focalized ischemic cerebral symptoms and two were asymptomatic. At angiography, all patients showed a typical image of "string of beads". Seven patients were operated on. Six had endoluminal graduated dilatation, with rigid dilators up to 4.5 mm, associated with thrombendarterectomy of the bifurcation in three and to correction of a kink in one case. In one case a venous interposition graft was done to exclude a saccular microaneurysm of the dysplasic internal carotid artery. In another case, backflow was insufficient after endoluminal dilatation, and a long venous patch allowed to restitute a normal vascular lumen. There was neither postoperative mortality nor stroke. Six patients, asymptomatic or with non focalized symptoms, were treated medically. During a mean follow-up of 47 months, only one of the 13 patients developed a transient ischemic attack; the patient had not been operated on and received only medical treatment. Prevalence, etiopathology, diagnosis and management of fibromuscular dysplasia of the internal carotid artery are discussed. Fibromuscular dysplasia is a rare cause of cerebral ischemia. For asymptomatic lesions, a conservative approach seems appropriate. Surgery is only to be considered for symptomatic lesions. Surgical graduated endoluminal dilatation, where necessary combined with standard endarterectomy of the carotid bifurcation, is a safe, efficient and durable operation. Some complex cases of fibromuscular dysplasia may necessitate patch insertion or excision and graft interposition.
http://hdl.handle.net/2268/112450

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