Posters
Presenting Author Academic/Professional Position
Medical Student
Academic Level (Author 1)
Medical Student
Discipline/Specialty (Author 1)
Internal Medicine
Academic Level (Author 2)
Medical Student
Discipline/Specialty (Author 2)
Internal Medicine
Academic Level (Author 3)
Medical Student
Discipline/Specialty (Author 3)
Internal Medicine
Presentation Type
Poster
Discipline Track
Clinical Science
Abstract Type
Research/Clinical
Abstract
Background: Fibromuscular Dysplasia (FMD) is a non-inflammatory vascular disease affecting medium-sized arteries, characterized by arterial stenosis, dissection, or aneurysm formation. While renal arteries are most involved, extrarenal manifestations, particularly in the carotid and vertebral arteries, are increasingly recognized. These non-renal presentations can lead to complications such as dissection, aneurysm, and ischemic events, influencing diagnosis and management strategies. This systematic review evaluates the prevalence and clinical impact of extrarenal FMD, with a focus on its role in patient outcomes and treatment.
Methods: A systematic review of PubMed, Science Direct, and Cochrane was conducted to identify studies published from 2000 to 2025. Keywords used included ("Fibromuscular Dysplasia") and ("carotid artery" or "vertebral artery") and ("arterial dissection" or "aneurysm" or "stroke" or "diagnostic imaging" or "therapy"). This search yielded 339 results. Exclusion criteria were applied to include only primary research studies. Finally, the inclusion criteria focused on patients with extrarenal Fibromuscular Dysplasia (FMD), particularly involving carotid or vertebral arteries, and reporting on prevalence, clinical presentation, complications, diagnosis, or management. This process identified 17 articles.
Results: Fibromuscular dysplasia (FMD) and related arterial issues, like carotid webs and dissections, carry serious risks for cerebrovascular events and systemic arterial involvement, including the renal, carotid, and vertebral arteries. Carotid webs, an intimal variant of FMD, are strongly linked to recurrent ischemic strokes, with recurrence rates reaching 27.3% at five years under medical management alone, while surgical or stenting interventions effectively prevent recurrences. Novel diagnostic markers, such as S-shaped internal carotid artery curves, were identified as predictors of dissections and underlying FMD. This shows the importance of advanced imaging techniques like 3.0-T MR angiography for accurate diagnosis. Comparisons between carotid artery stenting (CAS) and carotid endarterectomy (CEA) in randomized trials demonstrated both methods effectively reduced stroke risk, with stent design influencing outcomes, particularly procedural hypotension rates. CAS was comparable to CEA when performed by experienced medical professionals in large medical centers. In patients with symptomatic internal carotid elongation due to FMD, surgical correction proved superior to medical therapy, reducing late strokes and carotid occlusions while histology revealed characteristic FMD patterns in over half of the cases. These findings show the necessity of patient specific strategies and the potential benefits of surgical or interventional approaches in reducing recurrence and improving outcomes for patients with FMD.
Conclusions: Extrarenal involvement in Fibromuscular Dysplasia (FMD) is significant, with multisite vascular involvement. Surgical and endovascular treatments improve outcomes in symptomatic cases, reducing stroke recurrence and stabilizing lesions. The data emphasizes the importance of early diagnosis and treatment to reduce complications such as arterial dissection, aneurysm, and stroke, while identifying areas for further research to enhance patient outcomes.
Recommended Citation
Sepulveda, Alyssa L.; Gutierrez, Yolanda V.; and Shaju, Ronald A., "The Prevalence and Impact of Extrarenal Involvement in Fibromuscular Dysplasia: A Systematic Review" (2025). Research Symposium. 6.
https://scholarworks.utrgv.edu/somrs/2025/posters/6
The Prevalence and Impact of Extrarenal Involvement in Fibromuscular Dysplasia: A Systematic Review
Background: Fibromuscular Dysplasia (FMD) is a non-inflammatory vascular disease affecting medium-sized arteries, characterized by arterial stenosis, dissection, or aneurysm formation. While renal arteries are most involved, extrarenal manifestations, particularly in the carotid and vertebral arteries, are increasingly recognized. These non-renal presentations can lead to complications such as dissection, aneurysm, and ischemic events, influencing diagnosis and management strategies. This systematic review evaluates the prevalence and clinical impact of extrarenal FMD, with a focus on its role in patient outcomes and treatment.
Methods: A systematic review of PubMed, Science Direct, and Cochrane was conducted to identify studies published from 2000 to 2025. Keywords used included ("Fibromuscular Dysplasia") and ("carotid artery" or "vertebral artery") and ("arterial dissection" or "aneurysm" or "stroke" or "diagnostic imaging" or "therapy"). This search yielded 339 results. Exclusion criteria were applied to include only primary research studies. Finally, the inclusion criteria focused on patients with extrarenal Fibromuscular Dysplasia (FMD), particularly involving carotid or vertebral arteries, and reporting on prevalence, clinical presentation, complications, diagnosis, or management. This process identified 17 articles.
Results: Fibromuscular dysplasia (FMD) and related arterial issues, like carotid webs and dissections, carry serious risks for cerebrovascular events and systemic arterial involvement, including the renal, carotid, and vertebral arteries. Carotid webs, an intimal variant of FMD, are strongly linked to recurrent ischemic strokes, with recurrence rates reaching 27.3% at five years under medical management alone, while surgical or stenting interventions effectively prevent recurrences. Novel diagnostic markers, such as S-shaped internal carotid artery curves, were identified as predictors of dissections and underlying FMD. This shows the importance of advanced imaging techniques like 3.0-T MR angiography for accurate diagnosis. Comparisons between carotid artery stenting (CAS) and carotid endarterectomy (CEA) in randomized trials demonstrated both methods effectively reduced stroke risk, with stent design influencing outcomes, particularly procedural hypotension rates. CAS was comparable to CEA when performed by experienced medical professionals in large medical centers. In patients with symptomatic internal carotid elongation due to FMD, surgical correction proved superior to medical therapy, reducing late strokes and carotid occlusions while histology revealed characteristic FMD patterns in over half of the cases. These findings show the necessity of patient specific strategies and the potential benefits of surgical or interventional approaches in reducing recurrence and improving outcomes for patients with FMD.
Conclusions: Extrarenal involvement in Fibromuscular Dysplasia (FMD) is significant, with multisite vascular involvement. Surgical and endovascular treatments improve outcomes in symptomatic cases, reducing stroke recurrence and stabilizing lesions. The data emphasizes the importance of early diagnosis and treatment to reduce complications such as arterial dissection, aneurysm, and stroke, while identifying areas for further research to enhance patient outcomes.
