SUCCESSFUL TREATMENT OF INTERNAL CAROTID-ARTERY FIBROMUSCULAR DYSPLASIA BY PERCUTANEOUS TRANSLUMINAL ANGIOPLASTY

Fibromuscular dysplasia is sometimes a progressive disease which prese nts as transient neurological attacks, prolonged reversible ischaemic neurological deficits, completed strokes or subarachnoid haemorrhage. Therefore, several methods have been used to treat such potentially se rious diseases including carotid endarterectomy, excision of the invol ved segment, graduated internal dilatation and more recently percutane ous transluminal angioplasty. We are presenting our experience with a 35-year-old Saudi male who suffered from two ischaemic attacks, and wa s discovered to have a significant stenosis (80% diameter reduction) o f the right internal carotid artery (ICA) as diagnosed by colour Doppl er ultrasound, confirmed subsequently by digital subtraction angiograp hy (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 percutan eously by a 5 mm balloon catheter (5f, 2 cm-long balloon, 6 atmosphere pressure). No complications were encountered after the angioplasty. C areful selection of the patient is essential for the success of this t echnique.