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Fibromuscular Dysplasia, Carotid Kinks, and Other Rare Lesions

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Extracranial Carotid and Vertebral Artery Disease

Abstract

While most extracranial cerebrovascular pathologies are secondary to atherosclerosis, several hereditary and acquired conditions may also lead to devastating complications and should be familiar to the vascular specialist. Such conditions include fibromuscular dysplasia, carotid kinks and coils, and other rarer lesions such as Takayasu’s arteritis, giant-cell arteritis, Marfan’s syndrome, and vascular-type Ehlers-Danlos syndrome. Fibromuscular dysplasia is a non-atherosclerotic, noninflammatory arteriopathy that affects middle-sized vessels such as the renal and carotid arteries. It is a chronic, non-curable condition that should be managed medically, unless patients present with complications or are refractory to medical management. Elongated carotid artery abnormalities, including carotid tortuosity, coiling, or kinking, may lead to dissections, aneurysmal degenerations, and stroke and complicate attempts at endovascular repair of the carotid artery. Finally, the management of inflammatory arteriopathies such as Takayasu’s and giant-cell arteritis is primarily medical, but there are no consensus guidelines for these lesions because of their rarity. In this chapter, we will review the medical and operative management of these conditions and provide the reader with an approach to these conditions.

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Authors and Affiliations

  1. Vascular Surgery, University of Toronto, Toronto, ON, Canada

    Ahmed Kayssi

  2. Vascular Surgery, Inova Fairfax Hospital, Falls Church, VA, USA

    Dipankar Mukherjee

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  1. Ahmed Kayssi
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  1. Wayne State University School of Medicine, Detroit, MI, USA

    Sachinder Singh Hans

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Kayssi, A., Mukherjee, D. (2018). Fibromuscular Dysplasia, Carotid Kinks, and Other Rare Lesions. In: Hans, S. (eds) Extracranial Carotid and Vertebral Artery Disease. Springer, Cham. https://doi.org/10.1007/978-3-319-91533-3_19

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