CASE 50 Renal Artery Stenosis Resulting From Fibromuscular Dysplasia
Cardiac catheterization
A diagnostic cardiac catheterization was performed first and revealed mild coronary atherosclerosis with no significant obstruction and preserved left ventricular function. Selective right renal angiography demonstrated the characteristic findings of fibromuscular dysplasia with a “beaded” appearance of the renal artery and the presence of linear “webs” (Figure 50-1 and Video 50-1). This abnormality was also present to a lesser degree in the left renal artery (Figure 50-2 and Video 50-2). After administering 70 U/kg of unfractionated heparin, balloon dilatation was performed at these sites using a 5.5 mm diameter by 20 mm long balloon, which improved the angiographic appearance (Figures 50-3, 50-4 and Videos 50-3, 50-4).
