Renal fibromuscular dysplasia

Mousa, Albeir Y.; Gill, Gurpreet

doi:10.1053/j.semvascsurg.2014.06.006

Cited by 12 publications

(8 citation statements)

References 45 publications

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“…Stents and stent-grafts are reserved almost exclusively for treating angioplasty complications such as a dissection or vessel rupture (Meuse et al, 2010). Other techniques like renal artery denervation therapy or drug coated-balloon angioplasty has been recently described obtaining good outcomes (Mousa & Gill, 2013;Kelle et al, 2013;Morosetti et al, 2018) however more studies are needed before generalizing these new therapy options in the context of FMD. Surgical therapy is currently reserved for patients with patients with severe complications that cannot be handle with endovascular techniques (Gottsäter & Lindblad, 2014).…”

Section: Discussionmentioning

confidence: 99%

Endovascular management of an unsual case of spontaneous Retroperitoneal Haemorrhage due to Fibromuscular Dysplasia

et al. 2020

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Background Fibromuscular dysplasia (FMD) is an uncommon vascular disease that results in stenosis, dissection or aneurysmal degeneration. However, it can sometimes manifest atypically, as we show in this case. Case presentation A 24-year old patient with no relevant medical history with severe left hypochondrium pain. The physical examination showed blood pressure levels of 160/90 mmHg. An abdominopelvic CT evidenced left retroperitoneal haematoma associated with active bleeding and left renal artery stenosis. Given these findings, it was decided to perform an endovascular treatment. Significant stenosis was seen during the arteriography in both renal arteries, suggesting fibromuscular dysplasia and development of a collateral neovascular network responsible for the retroperitoneal haematoma. It was embolised in association with angioplasty of the left renal artery. The patient had a favourable outcome; however, high blood pressure levels persisted. A new bilateral renal angioplasty was performed, which returned blood pressure values to normal. The patient was discharged without needing antihypertensives. Conclusions FMD is a rare disease that can show multiple clinical presentations and need individualized treatment options. Endovascular techniques are in the first therapeutic line regarding fibromuscular dysplasia.

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Section: Discussionmentioning

confidence: 99%

Endovascular management of an unsual case of spontaneous Retroperitoneal Haemorrhage due to Fibromuscular Dysplasia

et al. 2020

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“…IVUS has been reported to be useful in diagnosing cystic adventitial disease [31]. In FMD, other authors have concluded that IVUS is likely more accurate than other modalities in characterizing the hemodynamic severity of encountered stenosis [39,41]. CTA Lower Extremity.…”

Section: Us Duplex Doppler Lower Extremitymentioning

confidence: 99%

ACR Appropriateness Criteria® Nonatherosclerotic Peripheral Arterial Disease

Imaging¹,

François

Skulborstad

et al. 2019

Journal of the American College of Radiology

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A broad range of nonatherosclerotic diseases affect the peripheral arteries. The appropriate initial diagnostic imaging studies vary, depending upon the clinical presentation and suspicion of disease. Accurate vascular imaging relies upon visualization of the vessel lumen, vessel wall, and surrounding soft-tissue structures, with some modalities also offering the ability to characterize blood flow direction and velocity. Furthermore, nonvascular findings are often paramount in supporting a suspected clinical syndrome or guiding surgical management. The scenarios discussed in this document include the initial evaluation of suspected popliteal entrapment syndrome, external iliac artery endofibrosis, lower-extremity inflammatory vasculitides, dissection or connective tissue disease, noninflammatory vascular disease, and vascular trauma.The American College of Radiology Appropriateness Criteria are evidence-based guidelines for specific clinical conditions that are reviewed annually by a multidisciplinary expert panel. The guideline development and revision include an extensive analysis of current medical literature from peer reviewed journals and the application of well-established methodologies (RAND/UCLA Appropriateness Method and Grading of Recommendations Assessment, Development, and Evaluation or GRADE) to rate the appropriateness of imaging and treatment procedures for specific clinical scenarios. In those instances where evidence is lacking or equivocal, expert opinion may supplement the available evidence to recommend imaging or treatment.Disclaimer: The ACR Committee on Appropriateness Criteria and its expert panels have developed criteria for determining appropriate imaging examinations for diagnosis and treatment of specified medical condition(s). These criteria are intended to guide radiologists, radiation oncologists, and referring physicians in making decisions regarding radiologic imaging and treatment. Generally, the complexity and severity of a patient's clinical condition should dictate the selection of appropriate imaging procedures or treatments. Only those examinations generally used for evaluation of the patient's condition are ranked. Other imaging studies necessary to evaluate other co-existent diseases or other medical consequences of this condition are not considered in this document. The availability of equipment or personnel may influence the selection of appropriate imaging procedures or treatments. Imaging techniques classified as investigational by the FDA have not been considered in developing these criteria; however, study of new equipment and applications should be encouraged. The ultimate decision regarding the appropriateness of any specific radiologic examination or treatment must be made by the referring physician and radiologist in light of all the circumstances presented in an individual examination.

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“…IVUS gives a detailed understanding of the severity of the stenosis and assists in accurate sizing of balloons. In addition, utilizing IVUS to evaluate restenosis after endovascular therapy for FMD can be extremely valuable …”

Section: Diagnosismentioning

confidence: 99%

“…In addition, utilizing IVUS to evaluate restenosis after endovascular therapy for FMD can be extremely valuable. 24 Finally, from a physiological point of view, measuring pressure gradients with a catheter or pressure wire is a diagnostic approach that remains controversial because the webs associated with FMD can be compressed and this may cause a false-negative reading. Additionally, there could be a flow-mediated impact on downstream tissue that is independent of the gradient.…”

Section: Imagingmentioning

confidence: 99%

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