Kelly T F, Morris G C
Am J Surg. 1982 Feb;143(2):232-6. doi: 10.1016/0002-9610(82)90076-9.
Fibromuscular dysplasia is being recognized more often as a significant pathologic vascular disease separate from atherosclerosis. The pathogenesis and pathology are still being investigated. This disease involves mainly three areas--renal, carotid and iliac arteries--with the renal area being the most common. Surgery has been used almost exclusively for symptomatic lesions, and the indications and procedures have been refined since the original procedures of resection and grafting. In patients with renal involvement, we first attempt to treat hypertension medically, followed by surgery if this is unsuccessful. In those with carotid involvement, we are very aggressive with symptomatic lesions since there is a 22 percent incidence of a significant preceding event in the patients operated on. In patients with iliac involvement, we treat according to symptoms. Graduated internal dilatation has been used very successfully alone and in combination with other methods. Postoperative follow-up and arteriography have shown the effects of surgery to be lasting and rewarding, with minimal morbidity and mortality and no recurrence.
纤维肌性发育不良作为一种有别于动脉粥样硬化的重要病理性血管疾病，正越来越多地被人们所认识。其发病机制和病理仍在研究中。这种疾病主要累及三个部位——肾动脉、颈动脉和髂动脉，其中以肾动脉受累最为常见。手术几乎仅用于有症状的病变，自最初的切除和移植手术以来，手术指征和操作方法已得到改进。对于有肾脏受累的患者，我们首先尝试药物治疗高血压，若治疗失败则进行手术。对于有颈动脉受累的患者，鉴于接受手术的患者中有22%的人在术前曾发生过严重的前驱事件，我们对有症状的病变采取非常积极的治疗措施。对于有髂动脉受累的患者，我们根据症状进行治疗。逐步进行的腔内扩张术单独使用或与其他方法联合使用都非常成功。术后随访和动脉造影显示，手术效果持久且令人满意，发病率和死亡率极低，且无复发。
