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Cardiologist, cardiac surgeon

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Fibromuscular dysplasia: causes, symptoms, diagnosis, treatment

Alexey Kryvenko, medical expert
Last reviewed: 04.07.2025

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Fibromuscular dysplasia includes a heterogeneous group of non-atherosclerotic non-inflammatory changes in arteries leading to vascular stenosis, occlusion, or aneurysm formation.

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Causes of fibromuscular dysplasia

Fibromuscular dysplasia usually occurs in women aged 40-60 years. The cause is unknown. However, genetic predisposition may play a role, and smoking may be a risk factor. Fibromuscular dysplasia most often develops in people with connective tissue disorders (e.g., Ehlers-Danlos syndrome type IV, cystic necrosis of the media, hereditary nephritis, neurofibromatosis).

Medial dysplasia is the most common type of pathology. It is characterized by alternating zones of thick and thin fibromuscular fibers containing collagen and located along the medial tunica (medial dysplasia) or extensive collagen deposition in the outer tunica (perimedial dysplasia). Fibromuscular dysplasia can affect the renal arteries (60-75%), carotid and intracranial (25-30%), intra-abdominal (9%) or external iliac (5%) arteries.

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Symptoms of fibromuscular dysplasia

Fibromuscular dysplasia is usually asymptomatic, regardless of the localization of the pathology. If clinical symptoms develop, the manifestations depend on the location of the pathological foci:

lameness, noise in the femoral vessels and weakened femoral pulse when the arteries of the leg are affected;
secondary arterial hypertension due to renal artery disease;
transient ischemic attacks or symptoms of stroke when the carotid arteries are affected;
symptoms of aneurysm in case of damage to intracranial arteries;
symptoms of ischemic bowel disease involving the mesenteric arteries (rare).

Diagnosis of fibromuscular dysplasia

A definitive diagnosis is made by vasography, which shows bead-like deformation of the arteries (in medial or perimedial dysplasia) or concentric or long band-like narrowing of the arteries (in other forms).

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Treatment of fibromuscular dysplasia

Treatment depends on the location. It may include percutaneous intravascular angioplasty, surgical bypass, or aneurysm removal. Smoking cessation is important. Control of other risk factors for atherosclerosis (hypertension, dyslipidemia, diabetes mellitus) helps prevent accelerated development of arterial stenosis.