PREVALENCE OF CEREBRAL ANEURYSMS IN PATIENTS WITH FIBROMUSCULAR DYSPLASIA - A REASSESSMENT

Object. The aim of this study was to determine the prevalence of cereb ral saccular aneurysms in patients with carotid artery and/or vertebra l artery (VA) fibromuscular dysplasia (FMD). Methods. A metaanalysis w as performed using data from 17 previously reported series of patients with internal carotid artery OCA) and/or VA FMD that included informa tion on the prevalence of cerebral aneurysms. In addition, the authors retrospectively evaluated their own series of 117 patients with ICA a nd/or VA FMD to determine the prevalence of cerebral aneurysms. The me taanalysis of the 17 earlier series, which included 498 patients, show ed a 7.6 +/- 2.5% prevalence of incidental, asymptomatic aneurysms in patients with ICA and/or VA FMD. In the authors' series of patients wi th FMD, 6.3 +/- 4.9% of patients harbored an incidental, asymptomatic aneurysm. When the authors' series was combined with those included in the metaanalysis, the prevalence was found to be 7.3 +/- 2.2%. The pr evalence of aneurysms in the general population would have to be great er than 5.6% for there to be no statistically significant difference ( chi-square test, p < 0.05) when compared with this 7.3% prevalence in patients with FMD. Conclusions. The prevalence of intracranial aneurys ms in patients with cervical ICA and/or VA FMD is approximately 7%, wh ich is not nearly as high as the 21 to 51% prevalence that has been pr eviously reported.