An Unusual Case of Fibromuscular Dysplasia with Bilateral Renal Macroaneurysms: Three-year Outcome After Endovascular Treatment

Abstract

Fibromuscular dysplasia (FMD) is an idiopathic, segmental, non-inflammatory and non-atherosclerotic disease that affects arterial walls, leading to stenosis of small and medium-sized arteries. FMD mostly involves renal and intracranial arteries and only in few patients is associated with macroaneurysms (RAAs). We present the case of a 45-years old woman with recent history of grade 2 hypertension that suffered of subarachnoid haemorrhage due to rupture of a basilar artery aneurysm. The cerebral aneurysm was immediately treated by coil embolization and an abdominal angio-CT scan was performed to investigate the presence of renovascular hypertension. The exam showed the presence of FMD of the renal arteries associated with presence of bilateral RAAs. Due to the high risk of rupture, the bigger aneurysm (2,5 cm diameter) present on the left artery was immediately treated by coil embolization. The fusiform aneurysm, present on the right renal artery, was instead treated one year later by using two flow diverter stents. After three years, an angiographic study showed that both cerebral and renal aneurysms were excluded from the blood flow without evidence of arterial restenosis.

Large volume haemorrhage following transoral robotic surgery (TORS) as a result of fibromuscular dysplasia: first reported case

“…A search of the literature for case reports, using the OvidMD and PubMed databases, with the search terms ‘FMD’ and ‘haemorrhage’ revealed 11 cases 7–11. Of these, only four actually described haemorrhagic complications of FMD7 8 10 11 ; all four related to intracranial haemorrhage, two resulting in fatal outcomes.…”

Bilateral renal artery stenosis in children with vomiting and hypokalemia

“…Histopatolojik olarak FMD periarteriyel fibroplazi, intimal fibroplazi ve medial displazi şeklinde görülebilir. Sıklıkla (%80-90) medial displazi olup, konvansiyonel anjiyografide tespih tanesi görünümü verir (11)(12).Çekilen BT anjiyografide sağ renal arterde aort çıkımında 7,5 mm'den sonra dolum defekti varken sol renal arterde aort çıkımdan itibaren yaklaşık 4 mm sonraki distal kesimde yaklaşık 8 mm'lik segmentte intimal kalınlaşma ve lümende yaklaşık %40-50 daralma izlenmesi, bizim olgumuzda intimal fibroplazi ile giden FMD varlığını düşündürmüştür. Olası yaş grubuna uygun diğer tanıların dışlanması tanımızı netleştirmiştir.…”