Visceral Fibromuscular Dysplasia: From asymptomatic disorder to emergency

Eur J Clin Invest. 2018 Nov;48(11):e13023. doi: 10.1111/eci.13023. Epub 2018 Sep 17.

Abstract

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.

Keywords: fibromuscular dysplasia; visceral.

Publication types

  • Review

MeSH terms

  • Aged
  • Aged, 80 and over
  • Angiography / methods
  • Asymptomatic Diseases*
  • Early Diagnosis
  • Emergencies
  • Emergency Treatment / methods
  • Female
  • Fibromuscular Dysplasia / diagnosis*
  • Fibromuscular Dysplasia / etiology
  • Fibromuscular Dysplasia / therapy
  • Healthy Lifestyle
  • Humans
  • Male
  • Platelet Aggregation Inhibitors / therapeutic use
  • Reperfusion
  • Viscera / blood supply

Substances

  • Platelet Aggregation Inhibitors