Percutaneous transluminal angioplasty of fibromuscular dysplasia of the internal carotid artery

Belán, A; Veselá, M; Vanĕk, I; Weiss, Karl-Heinz; Peregrin, J

doi:10.1007/bf02552082

Cited by 33 publications

(5 citation statements)

References 13 publications

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“…PTA is the first line of treatment for those with symptomatic extracranial cerebral vascular FMD. 4,[85][86][87][88] There is no role for the older technique of open graduated intraluminal dilatation. 89 Surgical therapy or endovascular therapy with stents or coils is reserved for patients with aneurysms.…”

Section: Differential Diagnosismentioning

confidence: 99%

Diagnosis, management, and future developments of fibromuscular dysplasia

Olin

Sealove

2011

Journal of Vascular Surgery

231

183

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Fibromuscular dysplasia (FMD) is a nonatherosclerotic noninflammatory vascular disease that primarily affects women from age 20 to 60, but may also occur in infants and children, men, and the elderly. It most commonly affects the renal and carotid arteries but has been observed in almost every artery in the body. FMD has been considered rare and thus is often underdiagnosed and poorly understood by many health care providers. There are, however, data to suggest that FMD is much more common than previously thought, perhaps affecting as many as 4% of adult women. When it affects the renal arteries, the most common presentation is hypertension. When it affects the carotid or vertebral arteries, the patient may present with transient ischemic attack or stroke, or dissection. An increasing number of patients are asymptomatic and are only discovered incidentally when imaging is performed for some other reason or by the detection of an asymptomatic bruit. FMD should be considered in the differential diagnosis of a young person with a cervical bruit; a "swishing" sound in the ear(s); transient ischemic attack, stroke, or dissection of an artery; or in individuals aged ≤ 35 years with onset hypertension. Treatment consists of antiplatelet therapy for asymptomatic individuals and percutaneous balloon angioplasty for patients with indications for intervention. Patients with aneurysms should be treated with a covered stent or open surgical repair. Little new information has been published about FMD in the last 40 years. The recently instituted International Registry for Fibromuscular Dysplasia will remedy that situation and provide observational data on a large numbers of patients with FMD.

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Section: Differential Diagnosismentioning

confidence: 99%

Diagnosis, management, and future developments of fibromuscular dysplasia

Olin

Sealove

2011

Journal of Vascular Surgery

231

183

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“…9,10 Effective experimentation with carotid angioplasty began in the mid 1970s 11,12 and rapidly developed during the subsequent 2 decades. [13][14][15][16][17] The contemporary era of carotid stenting began in 1994 when Roubin et al 18 instigated the first rigorous, prospective study of carotid stenting entailing independent neurological evaluation at baseline and at 30 days after procedure. This study, and the experience of others, 19 demonstrated that from the outset, carotid stenting performed by experienced operators produced acceptable outcomes.…”

Section: Historical Perspectivementioning

confidence: 99%

Realizing the Potential of Carotid Artery Stenting

et al. 2006

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Abstract-Carotid artery stenting, compared with carotid endarterectomy, is emerging as an effective and less invasive method of revascularization for extracranial carotid artery stenosis. Carotid stenting is established as the treatment of choice for certain high-risk patient subsets, and ongoing clinical trials are evaluating this method across a broader clinical spectrum, including asymptomatic patients. For carotid stenting to reach its full potential, an acceptable risk of periprocedural complications, particularly in low-risk patients, must be ensured (the "3% rule"). The present article provides an in-depth review of carotid stenting, with special emphasis on the process of risk stratification pertaining to clinical, anatomic, and procedural considerations necessary to optimize procedural safety and patient outcomes.

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“…It also plays a role as alternative treatment strategy for extracranial artery stenosis [2, 3, 4, 5, 6, 7, 8, 9, 10, 11, 12, 13]. PTA for the treatment of severe symptomatic carotid stenosis instead of carotid endarterectomy is controversely discussed [14, 15, 16, 17, 18].…”

Section: Introductionmentioning

confidence: 99%

Clinical and Ultrasonic Long-Term Results of Percutaneous Transluminal Carotid Angioplasty

Schöser

Becker²,

Eckert³

et al. 1998

Cerebrovasc Dis

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Experience of the long-term outcome of patients treated with carotid balloon angioplasty is limited. Therefore, we prospectively analyzed the ultrasonic and clinical features of 29 patients with complete follow-up data beyond 24 months, evaluated from 1989 through 1996 from our carotid angioplasty cohort of 106 patients. Mean follow-up time was 33 months. For up to 78 months postangioplasty, 23 patients with 24 angioplasties (77%) had no further neurological sequelae. Single ipsilateral amaurosis fugax or TIA events occurred in 3 patients. Recurrent ipsilateral amaurosis fugax or TIA events were noted twice in 2 patients. No patient suffered an ipsilateral stroke. Fifteen angioplasties (50%) remained with normal ultrasound (stenosis <50%), mild restenosis (50–70%) occurred in 12 angioplasties (40%), and severe restenosis (>70%) in 3 angioplasties (10%). Only in 2 of 15 patients clinical complications were related to the occurrence of ipsilateral restenosis above 50%. Until now, rigorous and careful evaluation of patients and clinical and ultrasonic follow-up have been essential for the estimation of the long-term efficacy of carotid angioplasty. It should be noted that carotid angioplasty is a new technique in evolution, with a high potential improving the technical results.

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Percutaneous transluminal angioplasty of fibromuscular dysplasia of the internal carotid artery

Cited by 33 publications

References 13 publications

Diagnosis, management, and future developments of fibromuscular dysplasia

Diagnosis, management, and future developments of fibromuscular dysplasia

Realizing the Potential of Carotid Artery Stenting

Clinical and Ultrasonic Long-Term Results of Percutaneous Transluminal Carotid Angioplasty

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