Fibromuscular dysplasia of renal arteries: percutaneous revascularization based on hemodynamic assessment with a pressure measurement guidewire.
Fibromuscular dysplasia (FMD) leading to renal artery stenosis and hypertension is one of the most common treatable causes of secondary hypertension. However, frequently it can be difficult to judge the anatomical severity of a stenotic lesion with various noninvasive and invasive imaging modalities. We present two patients with poorly controlled hypertension and FMD affecting the renal arteries, in whom there were no anatomically significant stenoses by renal magnetic resonance angiography or selective renal artery angiography. Utilizing a 0.014'' high fidelity micromanometer tipped PressureWire XT (Radi, Reading, MA), to measure intravascular pressure gradients throughout the diseased renal arteries, we identified physiologically significant stenoses, and successfully treated both patients with percutaneous transluminal angioplasty.
Division of Cardiovascular Medicine, San Diego School of Medicine, University of California, San Diego, California 92103-8784, USA. emahmud@ucsd.edu
Ehtisham
E
Mahmud
Michele
M
Brocato
Vachaspathi
V
Palakodeti
Sotirios
S
Tsimikas
D000328:Adult; D000800:Angioplasty, Balloon / Q000379:methods*; D001157:Arterial Occlusive Diseases / Q000150:complications / Q000473:pathology / Q000628:therapy*; D005260:Female; D005352:Fibromuscular Dysplasia / Q000150:complications / Q000473:pathology / Q000628:therapy*; D006801:Humans; D006977:Hypertension, Renal / Q000209:etiology; D018810:Magnetic Resonance Angiography; D012078:Renal Artery Obstruction / Q000209:etiology / Q000473:pathology / Q000628:therapy*