Focal renal artery stenosis caused by fibromuscular dysplasia: treatment by percutaneous transluminal angioplasty

We performed percutaneous transluminal angioplasty of the renal artery in five hypertensive patients with focal renal artery stenoses caused by fibromuscular dysplasia. In four patients, the hypertension decreased or resolved. In all patients, the stenoses displayed considerable resistance to dilatation, requiring maximum inflation of the angioplasty balloon with 10 atm of pressure (10.1 x 10(5) Pa). In two patients, the stenoses were extremely firm with a persistent waist noted in the maximally inflated balloon. One of these patients was left with a residual 40-50% stenosis after initial angioplasty, and a second attempt at dilatation after restenosis was also unsuccessful. This patient's blood pressure did not improve. When the results of our experience in these five patients were combined with 22 cases reported in the literature, we found that 23 (85%) of the 27 patients with focal renal artery stenoses caused by fibromuscular dysplasia had a decrease in blood pressure after percutaneous dilatation. Percutaneous transluminal angioplasty is an effective treatment for patients with renovascular hypertension caused by focal renal artery stenoses resulting from fibromuscular dysplasia.