Short report
Bilateral stenting of symptomatic and asymptomatic internal
carotid artery stenosis due to fibromuscular dysplasia
J Finsterera, J Strasseggerb, A Haymerlea, G Hagmüllerb
a Neurological
Department, Neurological Hospital Rosenhügel, Vienna, Austria, b Department of Vascular Surgery,
Wilhelminenspital, Vienna, Austria
Correspondence to: Dr J Finsterer, Sch 348, 1180 Wien, Austria fij{at}2nr.nkr.magwien.gr.at
Received 4 October
1999 and in revised form 19 April 2000;
Accepted 21 June
2000
Stent grafting of internal carotid artery (ICA) stenoses due to
fibromuscular dysplasia has been rarely and only unilaterally carried
so far. Bilateral carotid stent grafting of ICA stenoses due to
fibromuscular dysplasia has not been reported previously. In a 37 year
old woman with recurrent right hemispheric transitory ischaemic
attacks, a non-disabling minor stroke, and recurrent right amaurosis
fugax despite antithrombotic therapy, cerebral angiography disclosed a
long segment narrowing, distal, high grade (95%) stenosis of the right
ICA and a long narrowing, distal high grade (70%) stenosis of the left
ICA. Morphological features of both stenoses were indicative of
fibromuscular dysplasia. The right sided stenosis was stented with a
PTFE-HEMOBAHN® endoprosthesis; this was followed by a brief,
postprocedural left sided hemiparesis. The left sided ICA stenosis was
successfully stented by the same procedure. Nine months later, both
stents were still patent and the patient was symptom free. Bilateral
carotid stenting may remain an alternative to endarterectomy in
bilateral ICA stenosis due to fibromuscular dysplasia when ischaemic
events persist despite full antithrombotic therapy.
Keywords: carotid surgery; carotid dysplasia; internal carotid artery stenosis; angioplasty
© 2000 by Journal of Neurology, Neurosurgery, and Psychiatry
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Slovut, D. P., Olin, J. W.
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