Difficulty and importance of diagnosing stenosis of renal branch artery in fibromuscular dysplasia: a case report. (2nd November 2021)

• Record Type: Journal Article
• Authors: Skræddergaard, Andreas; Nyvad, Jakob; Christensen, Kent Lodberg; Hørlyck, Arne; Mafi, Hossein Mohit; Reinhard, Mark
• Is Part Of: Blood pressure. Volume 30:Number 6(2021)
• Page Start: 416
• Page End: 420
• Publication Date: 2021-11-02
• Subjects: Fibromuscular dysplasia -- renovascular hypertension -- renal artery stenosis -- percutaneous transluminal angioplasty -- abdominal pain -- adolescent; Blood pressure -- Periodicals; Hypertension -- Periodicals; Hypertension -- Periodicals; Blood Pressure -- Periodicals; 612.14
• DOI: 10.1080/08037051.2021.1993735
• Languages: English
• ISSNs: 0803-7051

Abstract

Abstract: A 16-year-old patient presented with abdominal pain and sustained hypertension. Thorough evaluation including renography with and without captopril and renal vein renin sampling were normal. Duplex ultrasound, however, raised suspicion of a renal artery stenosis. This was confirmed by computed tomography angiography which showed a severe branch artery stenosis with post-stenotic dilatation consistent with focal fibromuscular dysplasia (FMD). As the hypertension was resistant to 3 classes of antihypertensive treatment, percutaneous transluminal renal angioplasty (PTRA) was offered. The procedure had immediate effect on the blood pressure. Without medication the patient remains normotensive 4 years after and the abdominal pain has only sporadically returned. The presented case illustrates the challenging process of diagnosing FMD-related renal branch artery stenosis as well as the potential benefits of PTRA in this patient group.