ABSTRACT
Whereas the treatment options available are antithrombotic drugs, endarterectomy, or angioplasty, the optimal treatment of cervicocephalic FMD remains controversial. Vascular involvement in FMD tends to be higher in the neck or may involve longer or multifocal segments, compared to atherosclerotic disease. Transluminal dilatation of the carotid artery for FMD has hence been increasingly performed over the last two decades (16). Previously, it was performed by gradual dilatation of the artery using metal dilators, but over the years, the techniques have become more sophisticated with the use of transluminal balloon angioplasty, with stent placement. Manninen et al. (17) describe a patient with both the internal carotid arteries and both the vertebral arteries affected by FMD who was successfully treated by balloon angioplasty and stenting, and, in addition, had detachable coils placed in the pseudoaneurysms with excellent results at 1 year after the procedure. Finsterer et al. (18) describe their experience with a patient with FMD that had affected bilateral internal carotid arteries who remained symptomatic in spite of antithrombotic treatment. The patient received stenting procedures bilaterally, and in spite of a mild transient hemiparesis after the procedure, was asymptomatic after 9 months.
