title: Association between 2 angiographic subtypes of renal artery fibromuscular dysplasia and clinical characteristics.
abstract: BACKGROUND
  Initially based on histology, the diagnosis of renal artery fibromuscular dysplasia (FMD) is now based mostly on angiographic appearance because arterial tissue samples are rarely available. This retrospective cross-sectional study aimed to assess the clinical relevance of a binary angiographic classification of FMD lesions (unifocal or multifocal) based on computed tomographic or magnetic resonance angiography.
  
  
  RESULTS
  Adult patients diagnosed with FMD in a single tertiary care center for hypertension management were identified by screening of electronic files. FMD lesions were reviewed and classified according to computed tomography or magnetic resonance angiography as multifocal if there were at least 2 stenoses in the same arterial segment; otherwise, they were classified as unifocal. Of 337 patients with established renal artery FMD, 276 (82%) were classified as multifocal. Patients with unifocal and multifocal lesions differed significantly in median age at diagnosis of FMD (30 and 49 years) and hypertension (26 and 40 years), sex distribution (female:male ratio, 2:1 and 5:1), initial blood pressure (157/97 and 146/88 mm Hg), current smoking (50% and 26%), prevalence of unilateral renal artery lesions (79% and 38%), presence of kidney asymmetry (33% and 10%), renal revascularization procedures (90% and 35%), and hypertension cure rates in patients who underwent revascularization (54% and 26%).
  
  
  CONCLUSIONS
  A binary angiographic classification into unifocal or multifocal renal artery FMD is straightforward and discriminates 2 groups of patients with different clinical phenotypes.
authors.affiliation: Assistance Publique-Hoˆpitaux de Paris, Hoˆpital Europe´en Georges-Pompidou, Hypertension Unit, Paris, F-75015, France.
authors.forename: Sébastien
authors.initials: S
authors.lastname: Savard
authors.forename: Olivier
authors.initials: O
authors.lastname: Steichen
authors.forename: Arshid
authors.initials: A
authors.lastname: Azarine
authors.forename: Michel
authors.initials: M
authors.lastname: Azizi
authors.forename: Xavier
authors.initials: X
authors.lastname: Jeunemaitre
authors.forename: Pierre-François
authors.initials: PF
authors.lastname: Plouin
mesh_terms: D000328:Adult; D003430:Cross-Sectional Studies; D005260:Female; D005352:Fibromuscular Dysplasia / Q000000981:diagnostic imaging*; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D011859:Radiography; D012077:Renal Artery / Q000000981:diagnostic imaging; D012189:Retrospective Studies