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.
Abstract:
This article is a comprehensive document on the diagnosis and management of fibromuscular dysplasia (FMD), which was commissioned by the working group 'Hypertension and the Kidney' of the European Society of Hypertension (ESH) and the Society for Vascular Medicine (SVM). This document updates previous consensus documents/scientific statements on FMD published in 2014 with full harmonization of the position of European and US experts. In addition to practical consensus-based clinical recommendations, including a consensus protocol for catheter-based angiography and percutaneous angioplasty for renal FMD, the document also includes the first analysis of the European/International FMD Registry and provides updated data from the US Registry for FMD. Finally, it provides insights on ongoing research programs and proposes future research directions for understanding this multifaceted arterial disease.
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