Successful treatment of internal carotid artery fibromuscular dysplasia by percutaneous transluminal angioplasty

ABSTRACT

Fibromuscular dysplasia is sometimes a progressive disease which presents as transient neurological attacks, prolonged reversible ischaemic neurological deficits, completed strokes or subarachnoid haemorrhage. Therefore, several methods have been used to treat such potentially serious diseases including carotid endarterectomy, excision of the involved segment, graduated internal dilatation and more recently percutaneous transluminal angioplasty. We are presenting our experience with a 35-year-old Saudi male who suffered from two ischaemic attacks, and was discovered to have a significant stenosis [80% diameter reduction] of the right internal carotid artery [ICA] as diagnosed by colour Doppler ultrasound, confirmed subsequently by digital subtraction angiography [DSA]. The stenosis was a short segment in the proximal part of the right internal carotid artery just beyond the carotid bulb, probably due to fibromuscular dysplasia. This was successfully dilated percutaneously by a 5 mm balloon catheter [5f, 2 cm-long balloon, 6 atmosphere pressure]. No complications were encountered after the angioplasty. Careful selection of the patient is essential for the success of this technique