An Unusual Case of Bilateral Upper Extremity Ischemia Caused by Forearm Vessel Fibromuscular Dysplasia

Ann Vasc Surg. 2019 Apr:56:353.e7-353.e11. doi: 10.1016/j.avsg.2018.08.110. Epub 2018 Nov 27.

Abstract

Fibromuscular dysplasia (FMD) is a nonatherosclerotic disease that generally affects medium-sized arteries. The distribution typically involves the renal, extracranial carotid/vertebral, and iliac arteries. FMD in other vascular beds is rare. We herein present the case of a 47-year-old female with rapid-onset bilateral digital ischemia. Initial differential diagnosis included vasospastic disorders and vasculitis. An upper extremity arteriogram was suggestive of ulnar and radial FMD. Percutaneous intervention was not successful, and the patient was managed conservatively with symptomatic improvement. This case highlights the important diagnostic and therapeutic considerations in patients with less common etiologies of upper extremity ischemia.

Publication types

  • Case Reports

MeSH terms

  • Angiography
  • Female
  • Fibromuscular Dysplasia / complications*
  • Fibromuscular Dysplasia / diagnostic imaging
  • Fibromuscular Dysplasia / physiopathology
  • Fibromuscular Dysplasia / therapy
  • Forearm / blood supply*
  • Humans
  • Ischemia / diagnostic imaging
  • Ischemia / etiology*
  • Ischemia / physiopathology
  • Ischemia / therapy
  • Middle Aged
  • Regional Blood Flow
  • Treatment Outcome
  • Ultrasonography, Doppler, Color