Fibromuscular dysplasia of the internal carotid artery treated by operative transluminal balloon angioplasty.

Operative treatment of critical stenoses of the internal carotid artery secondary to fibromuscular dysplasia has been performed for nearly 2 decades using graduated metal dilators. While percutaneous transluminal balloon angioplasty of the internal carotid via the femoral artery has several advantages over the operative metal dilator method, cerebral embolization is a matter for concern. The authors have performed operative transluminal balloon angioplasty in such cases, permitting backbleeding with removal of any thrombi or debris. This technique combines the advantages of dilatation by a Grüntzig balloon with post-dilatation carotid backbleeding. Five patients have been successfully treated thus far using this technique.