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Abstract Details

Fibromuscular Dysplasia: The "Pulsation-Induced Mechanical Trauma" Theory
Cerebrovascular Disease and Interventional Neurology
P04 - (-)
077
BACKGROUND: Fibromuscular Dysplasia (FMD) is a relatively uncommon, non-inflammatory, non-atherosclerotic vascular condition of unknown etiology. There have been no major advancements in understanding FMD in the past 30-40 years.
DESIGN/METHODS: Radiology records at a large tertiary care medical center were queried for cases of cervical carotid FMD. Cases with viewable sequential angiographic evidence of FMD were selected and analyzed for degree of vessel tortuosity (none, mild, moderate or severe), FMD Type (Type I, II or III), degree of vessel movement or pulsation (none, some or significant), and the association with the FMD lesion. Images were independently analyzed by 1 neurologist and 2 neuroradiologists.
RESULTS: Twenty-four carotid vessels in fourteen patients were identified to have FMD, 100% of patients were female, average age was 58.43 卤 8.72yrs (range 45-73), 35.7% were black, 35.7% had HTN, 7.14% had CKD and 7.14% used tobacco in the past year. Two patients had family history of aneurysms, but no family history of FMD. There were 2 patients with associated aneurysms, 5 had distal aneurysms, and 2 dissections. All but 1 patient had at least mild vessel tortuosity, and 28.57% were mod-severe. All but 1 patient had "some" pulsation-like vessel movement, 16.67% had "significant" movement, and all movement was focally associated with the FMD abnormality.
CONCLUSIONS: Pulsation-like vascular movements were observed in high frequency and in high association with FMD. We propose a theoretical connection between the pulsation-induced movement and a process of reactive vascular hyperplasia and fibrosis responsible for the FMD phenotype and is consistent with previous findings.
Authors/Disclosures
Daniel Miller, MD
PRESENTER 		Dr. Miller has nothing to disclose.
No disclosure on file
No disclosure on file
Mitchell S. Elkind, MD, MS, FAAN Dr. Elkind has received personal compensation for serving as an employee of American Heart Association. Dr. Elkind has received personal compensation in the range of $10,000-$49,999 for serving as a Consultant for Atria Academy.