BACKGROUND The prevalence of cerebral aneurysms is increased in fibromuscular dysplasia (FMD). The presence of FMD may serve as discouragement to elective endovascular aneurysm treatment. Outcomes of endovascular intervention for aneurysms through vessels affected by FMD have not been reported. METHODS A prospectively maintained database of patients undergoing intracranial embolization was reviewed for patients with FMD who underwent endovascular aneurysm treatment. RESULTS A total of 1,025 patients were screened and 31 (3.0%) had cerebrovascular FMD. These patients underwent a total of 43 embolization procedures; 27 of these procedures were performed through an affected vessel. All but 1 patient were female and the average age was 62 years. "String-of-pearls"-type FMD was the most common subtype (90%). The internal carotid arteries were more commonly affected (65%) than the vertebral arteries (48%). All patients underwent treatment of cerebral aneurysms, most of which (87%) were incidentally discovered; 6 patients (19%) also had incidental vessel dissection. The average aneurysm size was 7.1 mm. The morphology was saccular in 93% of the cases, and 86% were in the anterior circulation. The most commonly performed treatment was flow diversion (67%), in the majority of cases by pipeline embolization. Other procedures performed were coiling (19%), stent-coiling (12%), and intrasaccular flow disruption (2%). All but 1 procedure (98%) were successful. There were no major complications; 1 patient experienced a transient ischemic attack. Follow-up angiography was performed in 88% of the cases, without evidence for disease progression after treatment. The average time to last angiographic follow-up was 17 months (±13). CONCLUSIONS Elective embolization of intracranial aneurysms can be performed safely through vessels affected by FMD.

中文翻译：

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肌纤维发育不良患者脑动脉瘤血管内治疗的安全性评估。

背景技术脑动脉瘤的患病率在纤维肌发育不良（FMD）中增加。FMD 的存在可能会阻碍选择性血管内动脉瘤治疗。通过受 FMD 影响的血管对动脉瘤进行血管内介入治疗的结果尚未见报道。方法 对接受血管内动脉瘤治疗的 FMD 患者前瞻性维护的颅内栓塞患者数据库进行审查。结果 共筛查了 1025 名患者，其中 31 名（3.0%）患有脑血管性 FMD。这些患者总共接受了 43 次栓塞手术；其中 27 次手术是通过受影响的血管进行的。除 1 名患者外，所有患者均为女性，平均年龄为 62 岁。“珍珠串”型口蹄疫是最常见的亚型（90%）。颈内动脉（65%）比椎动脉（48%）更常见。所有患者均接受了脑动脉瘤的治疗，其中大部分（87%）是偶然发现的；6 名患者（19%）也有偶然的血管夹层。平均动脉瘤大小为 7.1 毫米。93%的病例形态呈囊状，86%在前循环。最常进行的治疗是引流（67%），在大多数情况下是通过管道栓塞。进行的其他程序包括盘绕 (19%)、支架盘绕 (12%) 和囊内血流中断 (2%)。除 1 个程序 (98%) 外，所有程序均成功。没有重大并发症；1 名患者出现短暂性脑缺血发作。88% 的病例进行了随访血管造影，治疗后没有疾病进展的证据。到最后一次血管造影随访的平均时间为 17 个月 (±13)。结论 选择性栓塞颅内动脉瘤可以通过受 FMD 影响的血管安全地进行。