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Visceral Fibromuscular Dysplasia: From asymptomatic disorder to emergency
Author(s) -
Van der Niepen Patricia,
Tussenbroek Frank,
Devos Hannes,
Debing Erik,
Di Monaco Silvia,
Goffette Pierre,
Astarci Parla,
Persu Alexandre
Publication year - 2018
Publication title -
european journal of clinical investigation
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.164
H-Index - 107
eISSN - 1365-2362
pISSN - 0014-2972
DOI - 10.1111/eci.13023
Subject(s) - fibromuscular dysplasia , medicine , asymptomatic , cervical artery , radiology , disease , stenosis , epidemiology , pathogenesis , dysplasia , angiography , cardiology , renal artery , dissection (medical) , kidney
Fibromuscular dysplasia (FMD) is an idiopathic, segmental, non‐atherosclerotic and non‐inflammatory disease of the musculature of arterial walls, leading to stenosis of small and medium‐sized arteries, mostly involving renal and cervical arteries. As a result of better and more systematic screening, it appears that involvement of the splanchnic vascular bed is more frequent than originally assumed. We review epidemiology, pathogenesis, clinical picture as well as diagnosis and treatment of visceral artery (VA) FMD. The clinical picture is very diverse, and diagnosis is based on CT‐, MR‐ or conventional catheter‐based angiography. Involvement of VAs generally occurs among patients with multi‐vessel FMD. Therefore, screening for VA FMD is advised especially in renal artery (RA) FMD and in case of aneurysms and/or dissections. Treatment depends on the clinical picture. However, the level of evidence is low, and much of the common practice is extrapolated from visceral atherosclerotic disease.