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Case 16.2 

Case 16.2
Chapter:
Case 16.2
Author(s):

Christine U. Lee

, and James F. Glockner

DOI:
10.1093/med/9780199915705.003.0401
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date: 17 October 2019

59-year-old man with a history of hypertension

MIP image from 3D CE MRA (Figure 16.2.1) reveals prominent beading of the mid-distal right main renal artery.

Fibromuscular dysplasia

FMD, first reported by Leadbetter and Burkland in 1938, is a nonatherosclerotic, noninflammatory vascular disorder that occurs most often in women aged 20 to 60 years. It commonly involves the renal and extracranial carotid arteries, although any vascular territory can be affected. The renal arteries are affected in 75% of FMD patients, with bilateral involvement in more than 35%. Renal artery aneurysms are a fairly common complication of renal FMD and have been reported in 9% of patients. The incidence of FMD in the extracranial carotid arteries is uncertain. It was long accepted that carotid artery FMD occurred in 25% to 30% of patients with FMD; however, a much higher incidence of 70% has been identified for the first 200 patients enrolled in the FMD international registry. Vertebral arteries are less commonly involved than the carotid arteries. The etiology of FMD is unknown, but speculation has centered on hormonal and genetic factors....

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