Renal Artery Rupture in Association With Fibromuscular Dysplasia.

Area of Science:

• Vascular Medicine
• Nephrology
• Radiology

Background:

• Fibromuscular dysplasia (FMD) is a noninflammatory arteriopathy affecting medium-sized arteries.
• While often asymptomatic, FMD can lead to severe vascular complications like aneurysms and dissections.
• Renal artery involvement in FMD is common, but spontaneous bleeding is exceptionally rare.

Purpose of the Study:

• To report the first known case of spontaneous renal artery bleeding secondary to fibromuscular dysplasia without aneurysms.
• To review the potential pathophysiology of this rare complication.

Main Methods:

• Case report of a 49-year-old woman with sudden abdominal pain.
• Diagnostic angiography revealing active extravasation from a renal artery capsular branch.
• Review of existing literature on fibromuscular dysplasia and arterial bleeding.

Main Results:

• The patient presented with spontaneous, active blood extravasation from a renal artery branch.
• Angiography confirmed fibromuscular dysplasia in the renal arteries.
• No aneurysms were identified as the source of bleeding.

Conclusions:

• Spontaneous renal artery bleeding can occur in fibromuscular dysplasia even without evident aneurysms.
• This case expands the spectrum of known vascular complications of FMD.
• Further research into the underlying mechanisms of FMD-related bleeding is warranted.