Fibromuscular Dysplasia of the Internal Carotid Arteries

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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 6-yr period, 18 lesions were dilated. During a follow-up of 13-70 mo. (mean: 48.3 mo.), none of the patients operated on developed a stroke or hard ocular/neurologic symptoms in the territory of the artery/arteries operated upon. No patient 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 developed transient ischemic attacks or stroke during a follow-up period of 22-100 mo. (mean: 42 mo.). A rational plan of management apparently is dilatation of lesions associated with hard ocular/neurologic symptoms, and nonoperative management of asymptomatic patients and patients with global symptoms.