Unique presentation of renovascular hypertension due to fibromuscular dysplasia

Mitali Doshi; Peter Layman; Henri Justino; Mahmoud Malas

doi:10.1016/j.jvscit.2023.101257

Unique presentation of renovascular hypertension due to fibromuscular dysplasia

J Vasc Surg Cases Innov Tech. 2023 Jul 3;9(3):101257. doi: 10.1016/j.jvscit.2023.101257. eCollection 2023 Sep.

Authors

Mitali Doshi¹, Peter Layman², Henri Justino³, Mahmoud Malas²

Affiliations

¹ University of Massachusetts, Chan Medical School, Worcester, MA.
² Division of Vascular and Endovascular Surgery, University of California, San Diego, La Jolla, CA.
³ Division of Pediatric Cardiology, Rady Children's Hospital, San Diego, CA.

Abstract

A 21-year-old female with a history of right nephrectomy due to trauma presented with several years of multidrug-resistant hypertension. Her workup included negative findings from autoimmune and vasculitides panels and urine catecholamine testing. Computed tomography showed an acute hairpin turn of her left renal artery. Intraoperatively, the artery demonstrated kinking with exhalation. She underwent excision of the diseased portion of the renal artery and an end-to-end anastomosis. Final pathologic examination demonstrated fibromuscular dysplasia. This is a unique case of mechanical artery kinking combined with fibromuscular dysplasia contributing to renovascular hypertension, for which open surgery was beneficial at improving the patient's hypertension.

Keywords: Fibromuscular dysplasia; Renal artery; Renal artery stenosis; Renovascular hypertension.

Publication types

Case Reports