title: An Unusual Case of Fibromuscular Dysplasia with Bilateral Renal Macroaneurysms: Three-year Outcome After Endovascular Treatment.
abstract: Fibromuscular dysplasia (FMD) is an idiopathic, segmental, non-inflammatory and non-atherosclerotic disease that affects arterial walls, leading to stenosis of small and medium-sized arteries. FMD mostly involves renal and intracranial arteries and only in few patients is associated with macroaneurysms (RAAs). We present the case of a 45-years old woman with recent history of grade 2 hypertension that suffered of subarachnoid haemorrhage due to rupture of a basilar artery aneurysm. The cerebral aneurysm was immediately treated by coil embolization and an abdominal angio-CT scan was performed to investigate the presence of renovascular hypertension. The exam showed the presence of FMD of the renal arteries associated with presence of bilateral RAAs. Due to the high risk of rupture, the bigger aneurysm (2,5 cm diameter) present on the left artery was immediately treated by coil embolization. The fusiform aneurysm, present on the right renal artery, was instead treated one year later by using two flow diverter stents. After three years, an angiographic study showed that both cerebral and renal aneurysms were excluded from the blood flow without evidence of arterial restenosis.
authors.affiliation: Department of Medicine, University of Padova, Italy ; Medicina Interna I^, Ca' Foncello Hospital, Azienda ULSS 9, Treviso, Italy.
authors.forename: Roberta
authors.initials: R
authors.lastname: Buso
authors.forename: Marcello
authors.initials: M
authors.lastname: Rattazzi
authors.forename: Matteo
authors.initials: M
authors.lastname: Leoni
authors.forename: Massimo
authors.initials: M
authors.lastname: Puato
authors.forename: Francesco Di
authors.initials: FD
authors.lastname: Paola
authors.forename: Paolo
authors.initials: P
authors.lastname: Pauletto
keywords: bilateral renal macroaneurysms; endovascular treatment.; fibromuscular dysplasia; hypertension
references.citation: Cardiovasc Intervent Radiol. 2011 Jun;34(3):637-41
references.pmid: 21107566
references.citation: J Vasc Interv Radiol. 2011 Oct;22(10):1485-7
references.pmid: 21961983
references.citation: Cardiovasc Intervent Radiol. 2008 Jul;31 Suppl 2:S88-91
references.pmid: 17659425
references.citation: J Vasc Interv Radiol. 2000 Oct;11(9):1189-93
references.pmid: 11041477
references.citation: Eur J Clin Invest. 2012 Mar;42(3):338-47
references.pmid: 21854373
references.citation: Hypertension. 2010 Sep;56(3):525-32
references.pmid: 20625080
references.citation: Ann Surg. 2001 Oct;234(4):454-62; discussion 462-3
references.pmid: 11573039
references.citation: N Engl J Med. 2004 Apr 29;350(18):1862-71
references.pmid: 15115832
references.citation: Curr Opin Cardiol. 2008 Nov;23(6):527-36
references.pmid: 18830066
references.citation: Cardiovasc Intervent Radiol. 2011 Oct;34(5):926-35
references.pmid: 21387121
references.citation: Int Urol Nephrol. 2007;39(1):233-8
references.pmid: 17031504
references.citation: Ann Vasc Surg. 2010 Jul;24(5):695.e1-3
references.pmid: 20471218
references.citation: Ann Surg. 1983 Mar;197(3):348-52
references.pmid: 6830341
references.citation: Br J Urol. 1997 Jun;79(6):852-60
references.pmid: 9202549
references.citation: Orphanet J Rare Dis. 2007 Jun 07;2:28
references.pmid: 17555581
references.citation: Cardiovasc Intervent Radiol. 2006 Sep-Oct;29(5):875-8
references.pmid: 16786200
references.citation: Stroke. 1982 Jan-Feb;13(1):53-8
references.pmid: 7039003
references.citation: J Vasc Interv Radiol. 2008 Apr;19(4):487-92
references.pmid: 18375290