Angiographic Pattern Change in Fibromuscular Dysplasia

Abstract

Fibromuscular dysplasia (FMD) is an angiopathy that commonly affects the renal arteries but may affect other medium to large arteries, including the carotid artery. It has a variety of angiographic appearances, the most common of which is a string-of-beads pattern consisting of a segment of alternating stenoses and dilatations. This case documents that these patterns are not necessarily fixed. An initial angiogram in a patient with neurologic symptoms shows a string-of-beads pattern in the carotid artery. Later, this pattern is seen to convert to a smooth tubular form on follow-up arteriography. FMD may present angio graphically as a dynamic process.