title: Endovascular thrombectomy and stenting in the management of carotid fibromuscular dysplasia presenting with major ischemic stroke.
abstract: Fibromuscular dysplasia (FMD) affecting the internal carotid artery (ICA) is considered a benign condition; however, retinal and cerebral ischemic events may occur. We present a patient with carotid FMD presenting with a major ischemic stroke due to major embolic occlusion of the ICA in conjunction with a hemodynamic component caused by narrowing and beading of the lumen associated with FMD. The patient was successfully treated with intracranial stent-assisted thrombectomy followed by cervical ICA stenting that aimed to reconstruct and angioplasty the FMD-affected arterial segment. Recently, stent-based thrombectomy has emerged as the most effective endovascular option for the rapid revascularization of major intracranial occlusions; however, to our knowledge, its use in a rare case of FMD-associated major stroke has not yet been reported.
authors.affiliation: Department of Neurosurgery, Hadassah-Hebrew University Medical Center, POB 12000, Jerusalem 91120, Israel; Department of Endovascular Neurosurgery and Interventional Neuroradiology, Hadassah-Hebrew University Medical Center, Jerusalem, Israel. Electronic address: jcohenns@yahoo.com.
authors.forename: José E
authors.initials: JE
authors.lastname: Cohen
authors.affiliation: Department of Neurosurgery, Hadassah-Hebrew University Medical Center, POB 12000, Jerusalem 91120, Israel.
authors.forename: Eyal
authors.initials: E
authors.lastname: Itshayek
authors.affiliation: Department of Neurology, Hadassah-Hebrew University Medical Center, Jerusalem, Israel.
authors.forename: Galina
authors.initials: G
authors.lastname: Keigler
authors.affiliation: Department of Neurology, Hadassah-Hebrew University Medical Center, Jerusalem, Israel.
authors.forename: Roni
authors.initials: R
authors.lastname: Eichel
authors.affiliation: Department of Neurology, Hadassah-Hebrew University Medical Center, Jerusalem, Israel.
authors.forename: Ronen R
authors.initials: RR
authors.lastname: Leker
mesh_terms: D017130:Angioplasty; D001037:Aphasia / Q000209:etiology; D002545:Brain Ischemia / Q000150:complications*; D002343:Carotid Artery, Internal / Q000000981:diagnostic imaging / Q000473:pathology / Q000601:surgery*; D016893:Carotid Stenosis / Q000000981:diagnostic imaging / Q000209:etiology / Q000601:surgery*; D002533:Cerebral Angiography; D019468:Disease Management; D005260:Female; D005352:Fibromuscular Dysplasia / Q000150:complications* / Q000175:diagnosis / Q000601:surgery*; D006801:Humans; D008875:Middle Aged; D010291:Paresis / Q000209:etiology; D015607:Stents; D020521:Stroke / Q000000981:diagnostic imaging / Q000209:etiology*; D017131:Thrombectomy / Q000295:instrumentation / Q000379:methods; D016896:Treatment Outcome
keywords: Carotid artery; Fibromuscular dysplasia; Ischemic stroke; Stent; Thrombectomy