title: Acute aortic dissection and stroke in multivessel fibromuscular dysplasia.
abstract: Fibromuscular dysplasia is a rare, nonatherosclerotic, noninflammatory vascular disease that typically affects women between the ages of 20 and 60 years. Although any artery can be affected, fibromuscular dysplasia most commonly affects the renal and carotid arteries. Fibromuscular dysplasia of the renal arteries usually presents with hypertension, while carotid or vertebral artery disease causes transient ischemic attacks, strokes, or dissection. Fibromuscular dysplasia of the brachial arteries is extremely uncommon. It can induce extremity ischemia, nerve compression, or both-causing coldness, discoloration, pain, ulceration or gangrene of the fingers, paresthesias, or paralysis. We report a rare case of multivessel fibromuscular dysplasia manifested by acute stroke in association with type I aortic dissection, which progressed rapidly to ascending aortic false aneurysmal development that necessitated arch replacement. Outcomes of aortic arch replacement in this setting are currently unknown. Therefore, our case might well offer some insight.
authors: Division of Cardiovascular Medicine, University of Missouri Hospital-Columbia School of Medicine, Columbia, Missouri 65212, USA. skar762@aim.com
authors: Subrata
authors: S
authors: Kar
authors: Raja R
authors: RR
authors: Gopaldas
authors: Arun
authors: A
authors: Kumar
mesh_terms: D000208:Acute Disease; D000784:Aortic Dissection / Q000175:diagnosis / Q000209:etiology* / Q000601:surgery; D017541:Aneurysm, False / Q000175:diagnosis / Q000209:etiology* / Q000601:surgery; D001014:Aortic Aneurysm / Q000175:diagnosis / Q000209:etiology* / Q000601:surgery; D019917:Blood Vessel Prosthesis Implantation; D001916:Brachial Artery / Q000000981:diagnostic imaging / Q000473:pathology; D002339:Carotid Arteries / Q000000981:diagnostic imaging / Q000473:pathology; D005260:Female; D005352:Fibromuscular Dysplasia / Q000150:complications* / Q000175:diagnosis; D006801:Humans; D008279:Magnetic Resonance Imaging; D008875:Middle Aged; D011859:Radiography; D012077:Renal Artery / Q000000981:diagnostic imaging / Q000473:pathology; D020521:Stroke / Q000175:diagnosis / Q000188:drug therapy / Q000209:etiology*; D015912:Thrombolytic Therapy; D016896:Treatment Outcome
keywords: Aneurysm, dissecting/complications/etiology/pathology; aortic aneurysm, abdominal; aortic aneurysm, thoracic; blood vessel prosthesis implantation; brachial artery/pathology; carotid artery diseases/pathology; differential diagnosis; fibromuscular dysplasia/diagnosis/etiology/therapy; interventional cardiology; radial artery/access; renal artery/pathology