What is Fibromuscular Dysplasia (FMD)?
FMD is a congenital issue involving the walls of arteries throughout the body that makes them prone to local small areas of dilation. These local areas make the artery prone to issues such as clotting, or damage due to blood flow. All arteries in the body are affected in patients with FMD, but the blood vessels mostly affected that bring patients to medical attention include:
1. The renal (kidney) arteries – which cause high blood pressure
2. The carotid (brain) arteries – which can cause stroke
3. The femoral (leg) arteries – which can cause leg, calf, or foot pain
How is FMD Diagnosed?
Fibromuscular dysplasia is diagnosed with vascular ultrasound, and confirmed with an arteriogram. Vascular ultrasound is used first, as it is non-invasive, and easily performed in the outpatient office. When someone is diagnosed by ultrasound, the next step is arteriogram, which is performed through an IV catheter, using local anesthesia with a minor amount of IV sedation. Arteriogram uses catheters and contrast dye, which very specifically outlines the problem. At the same time, during the same arteriogram, the disease is able to be treated without an incision.
How is FMD Treated?
Fibromuscular dysplasia is treated primarily with angioplasty, which is using a balloon catheter to open up the narrowed segments of the affected artery. In general, this works very well, leaves no implant at all inside the patient, and has very good long term results. Stenting is not recommended in general in FMD patients. Some people affected with fibromuscular dysplasia eventually need surgical bypass, but this is typically the minority of patients.
When should FMD be treated?
In any surgical disease, treatment should occur when symptoms are apparent. In general however, in many vascular conditions, most patients are unaware of the symptoms, and especially unaware that their symptoms are due to a vascular problem. At our practice, we do our best to educate patients and help them make the safest decision.
What are the risks and benefits of treating FMD?
In general, the same as any surgical procedure. The risks include persistence of the problem, and eventually a vascular complication such as a blood clot, aneurysm, and damage to the organ as a result. The benefits are the prevention of complications and relief of symptoms. In general, in experienced hands, angioplasty for fibromuscular dysplasia is a very safe procedure. Rarely, damage to blood vessels and bleeding can occur.
We hope that this informational packet helped explain the most common questions about fibromuscular dysplasia, and options for treatment. If more questions arise, please feel free to contact your surgeon, and we can help alleviate your concerns. At NYC Surgical Associates, we believe our role is to gather information, present it in a format you can understand, and help you make the right decision for yourself, as we would do for our own family.