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David J. Effeney, MB, BS, FRACS; William K. Ehrenfeld, MD; Ronald J. Stoney, MD; Edwin J. Wylie, MD

Arch Surg. 1980;115(11):1261-1265.

Abstract
• Serious antecedent neurologic events occurred in 86 patients operated on for fibromuscular dysplasia (FMD). We applied the following criteria to the assessment of outcome: (1) the lesion should be surgically accessible; (2) the operation should be performed with minimal risk; (3) the operative repair is durable; and (4) benefits of repair are long lasting. Intraluminal dilation fulfills the first criterion: 118 dilations have been performed in 79 patients, with no deaths, three postoperative strokes that recovered completely, and eight single episodes of transient ischemia or amaurosis. The repair was durable, there being one late closure of a dilated artery. There were two subarachnoid hemorrhages, two strokes, and two patients had recurrence of symptoms during the follow-up period. Intraluminal dilation should be offered to patients with symptomatic FMD. A registry of patients with asymptomatic FMD should be established to study its natural history.

(Arch Surg 115:1261-1265, 1980)

Author Affiliations
From the Department of Surgery, University of California Medical Center (Drs Ehrenfeld, Stoney, and Wylie), and Surgical Service, Veterans Administration Medical Center (Dr Effeney), San Francisco.

Footnotes
Accepted for publication July 21, 1980.

Read before the 28th scientific meeting of the International Cardiovascular Society, Chicago, June 27, 1980.

Reprint requests to Veterans Administration Medical Center, 4150 Clement St, San Francisco, CA 94121 (Dr Effeney).

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