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[Fibromuscular dysplasia of renal arteries]
Pierre-François Plouin1, Béatrice Fiquet1, Guillaume Bobrie1
1Unité d'hypertension artérielle, centre de référence des maladies vasculaires rares, hôpital européen Georges-Pompidou, 20, rue Leblanc, 75015 Paris, France.
Abstract:
Fibromuscular dysplasia is non-atherosclerotic, non-inflammatory disease of the medium caliber arteries causing segmental stenosis, and sometimes aneurysm and/or dissection. Renal involvement is either asymptomatic or revealed by hypertension, rarely acute complications (renal infarction/hemorrhage). Cross-sectional imaging or angiography differentiates multifocal fibromuscular dysplasia (pearl necklace appearance) and focal fibromuscular dysplasia (tubular stenosis). Several differential diagnoses are to be mentioned. Carotid and vertebral involvement are possible. Smoking cessation must be encouraged. Selected patients benefit from renal revascularization. The best indications are recent or resistant hypertension, and progressive renal atrophy. Angioplasty without stent revascularization is the technique of choice in purely stenotic forms.
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