Assessment of renal artery fibromuscular dysplasia: angiography, intravascular ultrasound (with virtual histology), and pressure wire measurements

Catheter Cardiovasc Interv. 2009 Aug 1;74(2):260-4. doi: 10.1002/ccd.21968.

Abstract

Fibromuscular dysplasia (FMD) of the renal arteries is classically associated with secondary hypertension in younger individuals, which may be treatable and even curable by percutaneous transluminal renal angioplasty. Angiography of these renal arteries often displays "beaded" luminal abnormalities. The angiographic findings, however, may not accurately reflect the severity or precise location of the intraluminal obstruction. We present a case of an older individual with longstanding hypertension and FMD, in whom the use of a coronary pressure wire and intravascular ultrasound enabled precise localization and treatment of the hemodynamically significant stenosis. Virtual histology of FMD in the renal vasculature is also reported.

Publication types

  • Case Reports

MeSH terms

  • Aged
  • Angioplasty, Balloon, Coronary / instrumentation
  • Antihypertensive Agents / therapeutic use
  • Blood Pressure*
  • Drug Therapy, Combination
  • Female
  • Fibromuscular Dysplasia / complications
  • Fibromuscular Dysplasia / diagnosis*
  • Fibromuscular Dysplasia / physiopathology
  • Fibromuscular Dysplasia / therapy
  • Humans
  • Hypertension, Renovascular / drug therapy
  • Hypertension, Renovascular / etiology*
  • Hypertension, Renovascular / physiopathology
  • Image Interpretation, Computer-Assisted
  • Predictive Value of Tests
  • Radiography
  • Renal Artery / diagnostic imaging*
  • Renal Artery / physiopathology
  • Renal Artery Obstruction / diagnosis*
  • Renal Artery Obstruction / etiology
  • Renal Artery Obstruction / physiopathology
  • Renal Artery Obstruction / therapy
  • Severity of Illness Index
  • Stents
  • Ultrasonography, Interventional* / instrumentation
  • User-Computer Interface

Substances

  • Antihypertensive Agents