Skræddergaard A, Nyvad J, Christensen KL, Hørlyck A, Mafi HM, Reinhard M. Difficulty and importance of diagnosing stenosis of renal branch artery in fibromuscular dysplasia: a case report.
Blood Press 2021;
30:416-420. [PMID:
34697979 DOI:
10.1080/08037051.2021.1993735]
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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.
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