Patients With Fibromuscular Dysplasia

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]

Patients With Fibromuscular Dysplasia (FMD)

2011 ASA/ACCF/AHA/AANN/AANS/ACR/ASNR/CNS/SAIP/SCAI/SIR/SNIS/SVM/SVS Guideline on the Management of Patients With Extracranial Carotid and Vertebral Artery Disease (DO NOT EDIT)[1]

Recommendations for Management of Patients With Fibromuscular Dysplasia of the Extracranial Carotid Arteries

Class III (No Benefit)
"1. Revascularization is not recommended for patients with asymptomatic FMD (Fibromuscular dysplasia) of a carotid artery, regardless of the severity of stenosis. (Level of Evidence: C) "
Class IIa
"1. Annual noninvasive imaging of the carotid arteries is reasonable initially for patients with fibromuscular dysplasia (FMD) to detect changes in the extent or severity of disease, although the effect on outcomes is unclear. Studies may be repeated less frequently once stability has been confirmed. (Level of Evidence: C) "
"2. Administration of platelet-inhibitor medication can be beneficial in patients with FMD of the carotid arteries to prevent thromboembolism, but the optimum drug and dosing regimen have not been established. (Level of Evidence: C) "
"3. Carotid angioplasty with or without stenting is reasonable for patients with retinal or hemispheric cerebral ischemic symptoms related to FMD of the ipsilateral carotid artery, but comparative data addressing these methods of revascularization are not available. (Level of Evidence: C) "

References

  1. Brott TG, Halperin JL, Abbara S, Bacharach JM, Barr JD, Bush RL; et al. (2011). "2011 ASA/ACCF/AHA/AANN/AANS/ACR/ASNR/CNS/SAIP/SCAI/SIR/SNIS/SVM/SVS guideline on the management of patients with extracranial carotid and vertebral artery disease: executive summary. A report of the American College of Cardiology Foundation/American Heart Association Task Force on Practice Guidelines, and the American Stroke Association, American Association of Neuroscience Nurses, American Association of Neurological Surgeons, American College of Radiology, American Society of Neuroradiology, Congress of Neurological Surgeons, Society of Atherosclerosis Imaging and Prevention, Society for Cardiovascular Angiography and Interventions, Society of Interventional Radiology, Society of NeuroInterventional Surgery, Society for Vascular Medicine, and Society for Vascular Surgery". Circulation. 124 (4): 489–532. doi:10.1161/CIR.0b013e31820d8d78. PMID 21282505.

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