Combined open and endovascular stent grafting of internal carotid artery fibromuscular dysplasia: long term results.
BACKGROUND
Symptomatic fibromuscular dysplasia (FMD) of the internal carotid artery (ICA) can present as thrombo-embolic ischemic events, spontaneous or post-traumatic dissection, aneurysmal degeneration or intracranial haemorrhage and needs definitive surgical treatment.


METHODS
Six patients and nine ICA with FMD were revascularised using a carotid approach with minimal exposure of the common, external and internal carotid arteries for covered stent repair. All patients were female, the age ranged from 30 to 65 years (mean 44).


RESULTS
One patient suffered from a perioperative transient neurological deficit. Duplex revealed a patent stent. The patient fully recovered after 5h, not showing any changes on repeat CT scans. One patient developed a recurrent laryngeal nerve palsy. The symptoms gradually resolved within 1 month. No perioperative strokes or deaths occurred. During a mean follow up of 48 months (range 13-63) no thromboembolic neurological events, graft occlusions or haemodynamically significant stenoses occurred.


CONCLUSIONS
ICA FMD stent grafting is an alternative to open surgery or percutaneous endovascular intervention with excellent long-term results.
Assadian
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A
Department of General and Vascular Surgery, Wilheminenspital Vienna, Montleartstrasse 37, A-1160 Vienna, Austria. afshin_assadian@yahoo.de
Senekowitsch
C
C
Assadian
O
O
Schuster
H
H
Ptakovsky
H
H
Hagmüller
G W
GW
D000328:Adult; D000368:Aged; D000792:Angiography; D019917:Blood Vessel Prosthesis Implantation; D002340:Carotid Artery Diseases / Q000000981:diagnostic imaging / Q000601:surgery*; D002343:Carotid Artery, Internal / Q000000981:diagnostic imaging; D005260:Female; D005352:Fibromuscular Dysplasia / Q000000981:diagnostic imaging / Q000601:surgery*; D005500:Follow-Up Studies; D006801:Humans; D008875:Middle Aged; D015607:Stents; D016896:Treatment Outcome; D018616:Ultrasonography, Doppler, Duplex