Fibromuscular Dysplasia in Children and Adolescents

Figure 1. Conventional angiography. Panel A: Tight narrowing with a small aneurysm of 2 mm at the trifurcation of the left renal artery. Post balloon dilatation dimensions are shown in Panel B.
Figure 2. Conventional angiography. Panel A. In children, bilateral renal artery FMD is as common as unilateral FMD. Panel B. FMD rarely affects the carotid vessels in children, but these should be screened by CTA/MRA or at the time of conventional angiog
Figure 3. 3D CT angiography. Panel A. Left renal artery shows beading typical of FMD (arrow). Panel B. Renal artery with a long segment of narrowing with aneurysmal dilatation at the major bifurcation (arrow).
Figure 4. Conventional angiography. Tight stenosis of the right renal artery with marked post stenotic dilatation. Right nephrectomy was required after failed backbench repair to the thin-walled aneurysm.

Kevin E. C. Meyers, MD1,2 and Neha Sharma BA IV1,2;
The Children's Hospital of Philadelphia1 and the University of Pennsylvania
Philadelphia, Pennsylvania

While no prospective studies have evaluated the surgical treatment of renovascular FMD in children and young adults, it is reassuring to know that in selected patients less than 25 years of age, blood pressure is well-controlled and the majority of patients do not require anti-hypertensive medication post vascular repair. 26

The causes, natural history, management and long-term outcomes of FMD in children requires further research and evaluation.

The authors can be contacted at:
Kevin Meyers, MD
Pediatric Nephrologist

Assistant Professor of Pediatrics
Second Floor Main Building
The Children’s Hospital of Philadelphia Cnr
34th Street and Civic Center Boulevard
Philadelphia, PA 19104
Telephone: (215) 590-4155
Fax: (215) 590-3705
Email: [email protected]

Note: This article underwent double-blind peer review by members of the Cath Lab Digest Editorial Board.


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