Surgery of carotid kinking and fibromuscular dysplasia.

Case material on surgery of carotid artery totalled 258 operations. This paper refers to 52 patients suffering from carotid kinking or fibromuscular dysplasia. In all cases indication was based on clinical, radiographic and hemodynamic elements. Particular value is ascribed to radiographic pictures of different head positions and to photoplethysmographic studies conducted for the purpose of detecting circulatory insufficiency in the common carotid-internal carotid axis. Kinking: 43 cases: (1) 34 patients underwent shortening of internal carotid, with clamping limited to this vessel; (2) 2 patients underwent shortening of common carotid; (3) in the remaining 7 cases there was concomitant carotid atheromatosis so that simultaneous correction of both lesions was required. Fibromuscular dysplasia: 9 patients; these were subjected to intraluminal dilatation of the artery by means of Fogarty catheters or dilators. Good results exceeded 90% of all patients thus treated-all of whom presented marked cerebrovascular insufficiency. This figure has remained constant over the years.