First International Consensus on the diagnosis and management of fibromuscular dysplasia

Heather L Gornik1, Alexandre Persu2, David Adlam3,4

  • 11 Division of Cardiovascular Medicine, University Hospitals Cleveland Medical Center and UH Harrington Heart and Vascular Institute, Cleveland, OH, USA.

Insights

This comprehensive guide updates fibromuscular dysplasia (FMD) diagnosis and management, harmonizing European and US expert consensus. It offers clinical recommendations and registry data for this arterial disease.

Area of Science:

  • Vascular Medicine
  • Nephrology
  • Cardiology

Background:

  • Fibromuscular dysplasia (FMD) is a rare, non-atherosclerotic arterial disease affecting multiple vascular beds.
  • Previous consensus documents from 2014 require updating to reflect current knowledge and clinical practice.
  • Harmonization of European and US expert opinions is crucial for standardized FMD management.

Purpose of the Study:

  • To provide updated, comprehensive guidance on the diagnosis and management of fibromuscular dysplasia (FMD).
  • To harmonize clinical recommendations between European and US experts.
  • To present new data from FMD registries and propose future research directions.

Main Methods:

  • Consensus-based clinical recommendations developed by European Society of Hypertension (ESH) and Society for Vascular Medicine (SVM) working groups.
  • Inclusion of a consensus protocol for catheter-based angiography and percutaneous angioplasty for renal FMD.
  • Analysis of data from the European/International FMD Registry and updated data from the US FMD Registry.

Main Results:

  • Presents harmonized, consensus-based clinical recommendations for FMD diagnosis and management.
  • Includes a standardized protocol for diagnostic angiography and interventional procedures in renal FMD.
  • Provides novel insights from FMD registry analyses, enhancing understanding of disease prevalence and outcomes.

Conclusions:

  • This document serves as an updated, authoritative resource for clinicians managing patients with fibromuscular dysplasia.
  • The harmonized recommendations and registry data facilitate improved patient care and clinical decision-making.
  • Identifies critical areas for future research to further elucidate the pathophysiology and treatment of FMD.

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