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. 1981 Jul;194(1):89–96. doi: 10.1097/00000658-198107000-00016

Fibromuscular dysplasia of the internal carotid arteries. Clinical experience and follow-up.

G J Collins Jr, N M Rich, G P Clagett, M J Spebar, J M Salander
PMCID: PMC1345201  PMID: 7247539

Abstract

Fibromuscular dysplasia of the internal carotid arteries is a rare condition that may cause transient ischemic attacks, stroke and death. The preferred method of treatment of symptomatic lesions is graduated dilatation. Over a six year period, we have dilated 18 lesions. During a follow-up period ranging from 13 to 70 months (mean: 48.3 months), none of the patients operated on has developed a stroke or "hard" ocular/neurologic symptoms in the territory of the artery/arteries operated upon. Additionally, no patient has developed a stroke related to the contralateral asymptomatic, and consequently unoperated, carotid artery. Five patients with global symptoms have not had either carotid artery dilated and none has developed transient ischemic attacks or stroke during a follow-up period ranging from 22 to 100 months (mean: 42 months). These data demonstrate that a rational plan of management is dilatation of lesions associated with hard ocular/neurologic symptoms and nonoperative management of asymptomatic patients and patients with global symptoms.

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Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. Abdul-Rahman A. M., Abu-Salih, Brun A., Kin H., Ljunggren B., Mizukami M., Moquist-Olsson I., Sahlin Ch, Svendgaard N. A., Thulin C. A. Fibromuscular dysplasia of the cervico-cephalic arteries. Surg Neurol. 1978 Apr;9(4):217–222. [PubMed] [Google Scholar]
  2. CONNETT M. C., LANSCHE J. M. FIBROMUSCULAR HYPERPLASIA OF THE INTERNAL CAROTID ARTERY: REPORT OF A CASE. Ann Surg. 1965 Jul;162:59–62. doi: 10.1097/00000658-196507000-00010. [DOI] [PMC free article] [PubMed] [Google Scholar]
  3. Collins G. J., Jr, Hobson R. W., 2nd, Rich N. M., Levin I. Arterial dilator-shunt for use in carotid artery fibromuscular hyperplasia. Am J Surg. 1975 Sep;130(3):381–382. doi: 10.1016/0002-9610(75)90409-2. [DOI] [PubMed] [Google Scholar]
  4. Collins G. J., Jr, Rich N. M., Hobson R. W., Andersen C. Fibromuscular dysplasia of the internal carotid arteries. Surgery. 1977 Jan;81(1):105–110. [PubMed] [Google Scholar]
  5. Effeney D. J., Ehrenfeld W. K., Stoney R. J., Wylie E. J. Fibromuscular dysplasia of the internal carotid artery. World J Surg. 1979 Jul 16;3(2):179–186. doi: 10.1007/BF01561270. [DOI] [PubMed] [Google Scholar]
  6. Ehrenfeld W. K., Wylie E. J. Fibromuscular dysplasia of the internal carotid artery. Arch Surg. 1974 Nov;109(5):676–681. doi: 10.1001/archsurg.1974.01360050070016. [DOI] [PubMed] [Google Scholar]
  7. Ehrenfeld W. K., Wylie E. J. Fibromuscular dysplasia of the internal carotid artery. Arch Surg. 1974 Nov;109(5):676–681. doi: 10.1001/archsurg.1974.01360050070016. [DOI] [PubMed] [Google Scholar]
  8. Ehrenfeld W. K., Wylie E. J. Spontaneous dissection of the internal carotid artery. Arch Surg. 1976 Nov;111(11):1294–1301. doi: 10.1001/archsurg.1976.01360290128019. [DOI] [PubMed] [Google Scholar]
  9. Frens D. B., Petajan J. H., Anderson R., Deblanc J. H., Jr Fibromuscular dysplasia of the posterior cerebral artery: report of a case and review of the literature. Stroke. 1974 Mar-Apr;5(2):161–166. doi: 10.1161/01.str.5.2.161. [DOI] [PubMed] [Google Scholar]
  10. Gee W., Burton R., Stoney R. J. Atypical fibromuscular hyperplasia involving the carotid artery. Ann Surg. 1974 Jul;180(1):136–138. doi: 10.1097/00000658-197407000-00021. [DOI] [PMC free article] [PubMed] [Google Scholar]
  11. HILL L. D., ANTONIUS J. I. ARTERIAL DYSPLASIA: AN IMPORTANT SURGICAL LESION. Arch Surg. 1965 Apr;90:585–595. doi: 10.1001/archsurg.1965.01320100129020. [DOI] [PubMed] [Google Scholar]
  12. Harrison E. G., Jr, Hunt J. C., Bernatz P. E. Morphology of fibromuscular dysplasia of the renal artery in renovascular hypertension. Am J Med. 1967 Jul;43(1):97–112. doi: 10.1016/0002-9343(67)90151-9. [DOI] [PubMed] [Google Scholar]
  13. Harrison E. G., Jr, McCormack L. J. Pathologic classification of renal arterial disease in renovascular hypertension. Mayo Clin Proc. 1971 Mar;46(3):161–167. [PubMed] [Google Scholar]
  14. Hartman J. D., Young I., Bank A. A., Rosenblatt S. A. Fibromuscular hyperplasia of internal carotid arteries. Stroke in a young adult complicated by oral contraceptives. Arch Neurol. 1971 Oct;25(4):295–301. doi: 10.1001/archneur.1971.00490040021002. [DOI] [PubMed] [Google Scholar]
  15. Irey N. S., Manion W. C., Taylor H. B. Vascular lesions in women taking oral contraceptives. Arch Pathol. 1970 Jan;89(1):1–8. [PubMed] [Google Scholar]
  16. Morris G. C., Jr, Lechter A., DeBakey M. E. Surgical treatment of fibromuscular disease of the carotid arteries. Arch Surg. 1968 Apr;96(4):636–643. doi: 10.1001/archsurg.1968.01330220152024. [DOI] [PubMed] [Google Scholar]
  17. Osborn A. G., Anderson R. E. Angiographic spectrum of cervical and intracranial fibromuscular dysplasia. Stroke. 1977 Sep-Oct;8(5):617–626. doi: 10.1161/01.str.8.5.617. [DOI] [PubMed] [Google Scholar]
  18. PALUBINSKAS A. J., RIPLEY H. R. FIBROMUSCULAR HYPERPLASIA IN EXTRARENAL ARTERIES. Radiology. 1964 Mar;82:451–455. doi: 10.1148/82.3.451. [DOI] [PubMed] [Google Scholar]
  19. Palubinskas A. J., Perloff D., Newton T. H. Fibromuscular hyperplasia, an arterial dysplasia of increasing clinical importance. Am J Roentgenol Radium Ther Nucl Med. 1966 Dec;98(4):907–913. doi: 10.2214/ajr.98.4.907. [DOI] [PubMed] [Google Scholar]
  20. Perry M. O. Fibromuscular disease of the carotid artery. Surg Gynecol Obstet. 1972 Jan;134(1):57–60. [PubMed] [Google Scholar]
  21. Price R. A., Vawter G. F. Arterial fibromuscular dysplasia in infancy and childhood. Arch Pathol. 1972 May;93(5):419–426. [PubMed] [Google Scholar]
  22. Rainer W. G., Cramer G. G., Newby J. P., Clarke J. P. Fibromuscular hyperplasia of the carotid artery causing positional cerebral ischemia. Ann Surg. 1968 Mar;167(3):444–446. doi: 10.1097/00000658-196803000-00021. [DOI] [PMC free article] [PubMed] [Google Scholar]
  23. Stanley J. C., Fry W. J., Seeger J. F., Hoffman G. L., Gabrielsen T. O. Extracranial internal carotid and vertebral artery fibrodysplasia. Arch Surg. 1974 Aug;109(2):215–222. doi: 10.1001/archsurg.1974.01360020077015. [DOI] [PubMed] [Google Scholar]
  24. Upson J., Raza S. T. Fibromuscular dysplasia of internal carotid arteries: graduated internal dilatation by arterial Fogarty catheter. N Y State J Med. 1976 Jun;76(6):972–974. [PubMed] [Google Scholar]
  25. WYLIE E. J., WELLINGTON J. S. Hypertension caused by fibromuscular hyperplasia of the renal arteries. Am J Surg. 1960 Aug;100:183–193. doi: 10.1016/0002-9610(60)90290-7. [DOI] [PubMed] [Google Scholar]

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