Fibromuscular dysplasia (FMD) is a condition that causes narrowing (stenosis) and enlargement (aneurysm) of the medium-sized arteries in your body. The areas of narrowing and bulging occur next to each other and can cause the artery to narrow so much that organs that receive blood from the artery are damaged. Fibromuscular dysplasia can cause a number of complications, such as high blood pressure or tears of the artery (dissection), if left untreated. Symptoms: High blood pressure Tissue damage in your kidney (ischemic renal atrophy) Chronic kidney failure, rarely Headache Dizziness Blurred vision or temporary loss of vision Pulsating ringing in your ears (tinnitus) Neck pain Chronic headaches Facial weakness or numbness.
Diagnosis: FMD is currently diagnosed through the use of both invasive and non-invasive tests. Non-invasive testing includes duplex ultrasonography, magnetic resonance angiography (MRA), and computed tomographic angiography (CTA). Invasive testing through angiography is the gold standard. In addition, computed tomography angiography and magnetic resonance angiography are commonly used to evaluate arteries in the brain. Doppler ultrasound may be used in both the diagnosis.
Treament: There is no known cure for FMD. In cases of renal stenosis and indications for intervention, percutaneous balloon angioplasty may be recommended. The success rate of percutaneous transluminal angioplasty (PTA) in these cases, and have found relief of hypertensive symptoms. Duplex ultrasonography should be performed soon after this procedure to ensure adequate renal velocities. Medical therapy for pediatric population may involve the use of angiotensin-converting enzyme inhibitor (ACE inhibitors) and/or angiotensin II receptor blockers, multiple anti-hypertensive medications, diuretics, calcium channel blockers, and beta-blockers. Prevention of thrombosis of affected arteries may be taken through administration of an antiplatelet medication such as aspirin.
Epidemology: Regarding the risk of recurrent carotid artery dissection, de Bray et al prospectively reviewed 103 consecutive patients with carotid artery dissection with follow-up for an average of 4 years. Of those, 5 had recurrent dissections and 4 of the 5 patients with recurrent dissections were diagnosed with FMD. If considering the presentation of recurrent dissection of the carotid artery, FMD was associated in 80% of their series.