Distribution of Fibromuscular Dysplasia

Fibromuscular dysplasia (FMD) has a predilection for certain arteries. The renal arteries are most commonly affected, being involved in about 60% of cases. Cervicocranial arteries (most commonly the internal carotid arteries) are involved in about 30% of cases.

Unlike atherosclerosis, stenosis of the renal arteries due to FMD is rarely ostial or proximal, but usually truncal (white arrows) or distal (pink arrows) and may involve arterial branches. Stenoses are more common on the right. Renal lesions are bilateral in about 40% of cases.

The extracranial internal carotid artery is the second most commonly affected artery. Intracranial involvement is rare, but intracranial aneurysms can be seen in about 10%-50% of patients with carotid or vertebral artery involvement.

References

• Plouin PF, Perdu J, La Batide-Alanore A, Boutouyrie P, Gimenez-Roqueplo AP, Jeunemaitre X. Fibromuscular dysplasia. Orphanet J Rare Dis. 2007 Jun 7;2:28.
• Willoteaux S, Faivre-Pierret M, Moranne O, Lions C, Bruzzi J, Finot M, Gaxotte V, Mounier-Vehier C, Beregi JP. Fibromuscular dysplasia of the main renal arteries: comparison of contrast-enhanced MR angiography with digital subtraction angiography. Radiology. 2006 Dec;241(3):922-9