Renal Artery Stent Fracture in Patients With Fibromuscular Dysplasia

Fibromuscular dysplasia (FMD) is a nonatherosclerotic vascular disease that most commonly affects the renal, carotid, and vertebral arteries.1 Renal FMD is associated with renovascular hypertension, and patients may be referred for revascularization, generally with balloon angioplasty. We report a series of 2 patients with renal artery FMD who developed stent fracture.A 16-year-old girl was seen for a second opinion on renal FMD. Hypertension was diagnosed at the age of 13 years and initially treated medically; however, bilateral renal artery angioplasty was subsequently performed for poorly controlled blood pressure. She subsequently underwent placement of a drug eluting stent in the right renal artery for restenosis. Although she initially improved, there was gradual worsening of her blood pressure control. Noninvasive testing was consistent with severe restenosis of the right renal artery stent. Renal arteriography revealed a severe stenosis estimated at 80% in the right renal artery (Figure 1). There was severe narrowing noted at the ostium, resulting in a 70 mm Hg gradient across the lesion. …