Fibromuscular dysplasia

Case contributed by Dr Prashant Gupta

Presentation

CT angiogram for a prospective renal donor.

Patient Data

Age: 55-55 years old
Gender: Female

There is tandem narrowing seen in mid 1/3rd of both renal arteries resulting in a "string of beads" appearance. note that the ostium is spared and no atherosclerotic changes are seen in Aorta.

Case Discussion

FMD is a group of nonatherosclerotic, noninflammatory arterial diseases that most commonly involve the renal and carotid arteries

Angiographic classification includes the multifocal type, with multiple stenoses and the 'string-of-beads' appearance that is related to medial FMD, and tubular and focal types, which are not clearly related to specific histological lesions 

Multifocal stenoses with the 'string-of-beads' appearance are observed at angiography in more than 80% of cases, mostly in women aged between 30 and 50 years; they generally involve the middle and distal two-thirds of the main renal artery 

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