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Renal artery FMD
Treatment & FU
No optimal monitoring protocol, nor in case of
medical treatment alone, nor post revascularization
Persu et al. J Hypertens 2014; 32(7):1367-78. Olin et al. Circulation 2014; 129: 1048-78
After revascularization (restenosis in 25%)
Clinical evaluation
at 1 mth: BP, antiHT Treatment and kidney function 3-monthly: BP
Renal imaging
at 6 mth (cave restenosis) or before if BP or KF Annually (or 6-monthly first 24 mths, then yearly)
True Restenosis or Suboptimal initial PTRA?
FMD is a sytemic vascular disease
Different vascular beds and of multiple-site involvement
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By contrast, the % provided in the US registry correspond to the ratio of patients with FMD lesions of the corresponding vascular beds to the number of patients imaged for these vascular beds. This may lead to a substantial overestimation in some cases, as imaging of rarely involved vascular beds was targeted according to
- symptoms. In particular, imaging of lower limbs was performed only in a minority of patients (n=70), mostly in
presence of claudication. In addition, for the US registry, the column ‘supra-aortic trunks’ refers to extracranial carotid artery involvement. The corresponding percentage for vertebral arteries was 36.6%.
Flanders survey (n=123)
Frequency (%) of involvement of different vascular beds and of multiple-site involvement in series of patients with FMD from the US registry and cohorts
- f FMD patients from Paris, Zürich , Brussels and
- Flanders. The percentages provided for the four
European cohorts correspond to the proportion of patients in whom FMD lesions of each vascular bed were found. As not all vascular beds were imaged in all patients and different imaging methods were used, the % may correspond to an underestimation.
Persu et al. J Hypertens 2014; 32(7):1367-78. Olin et al. Circulation 2012; 125: 3182-90 M De Groote, P Van der Niepen et al. Vasa 2017, 1–8
ARCADIA (n=486)
Plouin PF. J Hypertens 2016.
Prevalence
