Treatment of renal artery fibromuscular dysplasia.
Fibromuscular dysplasia is a nonatherosclerotic and noninflammatory disease that can result in stenoses of the renal arteries and hypertension, most commonly affecting middle-aged women. Percutaneous transluminal angioplasty has long been considered the mainstay of therapy and offers high rates of improved or cured hypertension. The disease involves the mid and distal renal arteries and branchpoints and poses endovascular treatment challenges that separate fibromuscular dysplasia from atherosclerotic disease. The development of smaller balloon dilation systems offers safe and highly effective endovascular treatment options for technically difficult lesions. Newer technologies such as cutting balloons also add to the armamentarium of treatment choices, which may be useful in the setting of resistant stenoses. This article focuses on the modern technical considerations in the diagnostic evaluation and endovascular treatment of renal artery fibromuscular dysplasia.
Meuse
Michael A
MA
Department of Angiography and Interventional Radiology, University of Virginia Health, Charlottesville, VA, USA.
Turba
Ulku C
UC
Sabri
Saher S
SS
Park
Auh-Whan
AW
Saad
Wael E A
WE
Angle
J Fritz
JF
Matsumoto
Alan H
AH
D015901:Angiography, Digital Subtraction; D000800:Angioplasty, Balloon / Q000295:instrumentation; D004867:Equipment Design; D005352:Fibromuscular Dysplasia / Q000150:complications / Q000000981:diagnostic imaging / Q000628:therapy*; D006801:Humans; D015641:Radiography, Interventional; D012078:Renal Artery Obstruction / Q000000981:diagnostic imaging / Q000209:etiology / Q000628:therapy*; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome