Cephalic Fibromuscular Dysplasia in 32 Patients

So, Elson L.; Toole, James F.; Dalal, P. M.; Moody, Dixon M.

doi:10.1001/archneur.1981.00510100047006

Cited by 95 publications

(8 citation statements)

References 24 publications

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“…Although, to our knowl edge, there exists no comparable study in the literature, these results are in line with the frequency of involvement of different arterial beds in patients with FMH published in the literature [19]. Larger series have been published only in renovascular and cerebral FMH [II, 13,[19][20][21][22][23][24]. Less-frequent localisations such as the subclavian, intes tinal.…”

Section: Discussionsupporting

confidence: 51%

Fibromuscular Hyperplasia: Extension of the Disease and Therapeutic Outcome

Lüscher¹,

Keller

Imhof

et al. 1986

Nephron

101

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92 patients with fibromuscular hyperplasia (FMH) seen at the University Hospital Zurich were studied. Renovascular FMH was the most frequent manifestation of the disease (89%). FMH of the cerebral arteries was seen in 26%. The intestinal and subclavian arteries were involved in 9% each and the iliac arteries in 5% of the patients. In 2 patients each FMH of the abdominal aorta or the coronary arteries, respectively, was found. 26% of the patients had systemic disease with involvement of 2 or more arteries. Half of the patients with bilateral renovascular disease showed additional extrarenal FMH. All patients with renovascular FMH were hypertensive (mean blood pressure 194 ± 34/119 ± 18 mm Hg). Surgery, percutaneous transluminal angioplasty (PTA) and medical therapy were equally effective in controlling blood pressure. The cure rates were 52% in patients undergoing surgery and 50% in those treated with PTA. The complication rate, however, was higher with surgery (11%) than with PTA (3%). 62% of the patients treated medically were normotensive. Major side effects occurred in 4.8%. The outcome of curative interventions (surgery or PTA) was influenced by the extension of FMH. In unilateral disease the cure rate was significantly higher (62%) than in systemic FMH (28%; p < 0.03). Patients with strict bilateral disease were cured in 50%. We conclude: (a) PTA seems to be the treatment of choice in renovascular FMH because of a high cure and a low complication rate and (b) the outcome of curative interventions seems markedly influenced by the extension of FMH in these patients.

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Section: Discussionsupporting

confidence: 51%

Fibromuscular Hyperplasia: Extension of the Disease and Therapeutic Outcome

Lüscher¹,

Keller

Imhof

et al. 1986

Nephron

101

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“…105 This was first described in the renal arteries in 1938. 106 Atherosclerosis does, however, account for the vast majority of stenoses reported.…”

Section: Fibromuscular Dysplasiamentioning

confidence: 96%

Pathophysiology of extracranial cerebral arterial stenosis--a critical review.

Grady¹

1984

Stroke

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“…Fibromuscular dysplasia tends to occur in women, typically during the middle-age years, between the ages of 40 to 70 [15]. Middle-aged women are affected in approximately 85% of cervicocephalic FMD cases, with a mean age in the mid-50s [16,17].…”

Section: Clinical Featuresmentioning

confidence: 99%

“…With regard to symptomatic patients, symptoms can occur for several reasons: tight arterial, flow-limiting stenosis, artery-to-artery embolization, arterial thrombosis, arterial dissection, or from intracranial aneurysm rupture [15,16]. An estimated 56% of individuals with cervicocephalic FMD experience sudden, focal, ischemic neurologic deficits [15].…”

Section: Clinical Featuresmentioning

confidence: 99%

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Cerebrovascular complications of fibromuscular dysplasia

Leary

Finley

Caplan

2004

Curr Treat Options Cardiovasc Med

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Patients with cerebral ischemia or hemorrhage due to fibromuscular dysplasia (FMD) should be admitted to a monitored hospital bed and receive supportive stroke care. Based on our personal clinical experience, we recommend antiplatelet agents for future stroke prevention in patients with symptomatic FMD. In patients with watershed stroke due to hemodynamically significant FMD, our opinion is that hypertensive, hypervolemic therapy should be initiated immediately. Additionally, we suggest that potential revascularization therapies, such as intraoperative or primary percutaneous angioplasty, should be discussed.

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Cephalic Fibromuscular Dysplasia in 32 Patients

Cited by 95 publications

References 24 publications

Fibromuscular Hyperplasia: Extension of the Disease and Therapeutic Outcome

Fibromuscular Hyperplasia: Extension of the Disease and Therapeutic Outcome

Pathophysiology of extracranial cerebral arterial stenosis--a critical review.

Cerebrovascular complications of fibromuscular dysplasia

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