Fibromuscular dysplasia - results of a multicentre study in Flanders
Marie De Groote1, Patricia Van der Niepen2, Dimitri Hemelsoet3
11 Ghent University, Ghent, Belgium.
Background:
Fibromuscular dysplasia (FMD) is an idiopathic, non-inflammatory, non-atherosclerotic vascular disease, resulting in focal narrowing of small and medium-sized arteries. Systematic recording of clinical data in central databases as in the US and France provided new insights into FMD. The main objectives of this multicentre study were to explore the epidemiology, pattern of vascular involvement, clinical manifestations, and management of FMD patients in Flanders.
Patients And Methods:
Multicentre, retrospective registry of patients diagnosed with FMD based on medical imaging.
Results:
Hundred-twenty-three FMD patients (83.7 % female) were included. Mean age at FMD diagnosis was 57.3 years (SD 15.8). More than half of patients (59.5 %) were hypertensive at the time of diagnosis. Neurological complaints such as headache (26.4 %) and dizziness (23.1 %) were also frequently reported. FMD was discovered incidentally in 10 patients (8.3 %). Nearly one quarter (22.8 %) of patients experienced a cerebrovascular event. Aneurysms were found in one-fifth (20.3 %) of patients and 11.4 % had an arterial dissection. FMD affected most frequently the renal (85.3 %), carotid (74.7 %), and vertebral (39.8 %) arteries. Renovascular FMD was more prevalent in men, whereas cerebrovascular FMD was more frequent in women. Multiple affected sites were documented in 25 of 61 (41.0 %) patients, having two or more vascular beds imaged. Digital subtraction angiography was most frequently used for detecting FMD. One third (32.9 %) of patients received an interventional treatment, mainly patients with renovascular FMD (32.8 % underwent percutaneous transluminal angioplasty) and patients with an intracranial carotid aneurysm (36.4 % were treated by means of coiling).
Conclusions:
Although differences existed, results of the Flemish registry were broadly in line with the US and French registries. Patient databases help to learn more about the natural history, progression, and management of FMD, based on real life clinical evidence.
Insights
Fibromuscular dysplasia (FMD) is a vascular disease affecting arteries. This registry highlights FMD epidemiology, manifestations, and management in Flanders, aligning with international findings.
Area of Science:
- Vascular Medicine
- Epidemiology
- Medical Imaging
Background:
- Fibromuscular dysplasia (FMD) is an idiopathic, non-atherosclerotic arterial disease causing focal narrowing.
- Centralized patient data from the US and France have advanced FMD understanding.
- This study aimed to characterize FMD in Flanders.
Purpose of the Study:
- To explore the epidemiology of FMD in Flanders.
- To describe the pattern of vascular involvement and clinical manifestations.
- To analyze the management strategies for FMD patients.
Main Methods:
- A multicenter, retrospective registry was established.
- Patients diagnosed with FMD via medical imaging were included.
- Clinical data were systematically recorded.
Main Results:
- 123 FMD patients (83.7% female, mean age 57.3 years) were analyzed.
- Hypertension (59.5%), neurological symptoms (headache, dizziness), cerebrovascular events (22.8%), aneurysms (20.3%), and arterial dissection (11.4%) were common.
- Renal (85.3%), carotid (74.7%), and vertebral (39.8%) arteries were most frequently affected, with site prevalence differing by sex.
- Digital subtraction angiography was the primary diagnostic tool.
- Interventional treatment was provided to 32.9% of patients, primarily for renovascular FMD and intracranial carotid aneurysms.
Conclusions:
- Flemish FMD registry findings are consistent with US and French data.
- Patient databases are crucial for understanding FMD's natural history and management.
- Real-world clinical evidence from registries enhances FMD knowledge.
