Fibromuscular hyperplasia: extension of the disease and therapeutic outcome. Results of the University Hospital Zurich Cooperative Study on Fibromuscular Hyperplasia

Nephron. 1986;44 Suppl 1:109-14. doi: 10.1159/000184059.


92 patients with fibromuscular hyperplasia (FMH) seen at the University Hospital Zurich were studied. Renovascular FMH was the most frequent manifestation of the disease (89%). FMH of the cerebral arteries was seen in 26%. The intestinal and subclavian arteries were involved in 9% each and the iliac arteries in 5% of the patients. In 2 patients each FMH of the abdominal aorta or the coronary arteries, respectively, was found. 26% of the patients had systemic disease with involvement of 2 or more arteries. Half of the patients with bilateral renovascular disease showed additional extrarenal FMH. All patients with renovascular FMH were hypertensive (mean blood pressure 194 +/- 34/119 +/- 18 mm Hg). Surgery, percutaneous transluminal angioplasty (PTA) and medical therapy were equally effective in controlling blood pressure. The cure rates were 52% in patients undergoing surgery and 50% in those treated with PTA. The complication rate, however, was higher with surgery (11%) than with PTA (3%). 62% of the patients treated medically were normotensive. Major side effects occurred in 4.8%. The outcome of curative interventions (surgery or PTA) was influenced by the extension of FMH. In unilateral disease the cure rate was significantly higher (62%) than in systemic FMH (28%; p less than 0.03). Patients with strict bilateral disease were cured in 50%. We conclude: (a) PTA seems to be the treatment of choice in renovascular FMH because of a high cure and a low complication rate and (b) the outcome of curative interventions seems markedly influenced by the extension of FMH in these patients.

MeSH terms

  • Adult
  • Angioplasty, Balloon / adverse effects
  • Antihypertensive Agents / adverse effects
  • Antihypertensive Agents / therapeutic use
  • Arterial Occlusive Diseases / therapy*
  • Cerebral Angiography
  • Female
  • Fibromuscular Dysplasia / diagnostic imaging
  • Fibromuscular Dysplasia / surgery
  • Fibromuscular Dysplasia / therapy*
  • Humans
  • Hypertension, Renovascular / etiology
  • Hypertension, Renovascular / therapy*
  • Intestines / blood supply
  • Male
  • Middle Aged
  • Renal Artery / diagnostic imaging
  • Renin / blood
  • Subclavian Artery / diagnostic imaging


  • Antihypertensive Agents
  • Renin