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Endovascular Therapy for Fibromuscular Dysplasia of the Bilateral External Iliac Arteries Visualized with Optical Coherence Tomography

Takeshi Niizeki, Mitsunori Ishino, Tatsuro Kitahara, So Yamauchi, Eiichiro Ikeno, Isao Kubota

(Department of Cardiology, Okitama Public General Hospital, Kawanishi, Yamagata, Japan)

Am J Case Rep 2015; 16:187-190

DOI: 10.12659/AJCR.893167

Published: 2015-03-27

Background: Fibromuscular dysplasia (FMD) is a non-inflammatory, non-atherosclerotic, degenerative vascular disease that most frequently affects renal and carotid arteries in women aged 30–50 years, and rarely complicating arteries of the lower limbs.
Case Report: A 60-year-old woman was admitted with intermittent claudication of both legs. We performed pelvic and bilateral lower-extremities angiography, which revealed that the bilateral external iliac arteries (EIAs) had the ‘string of beads’ appearance with a diagnosis of FMD. Endovascular therapy (EVT) was performed for the bilateral EIAs. Optical coherence tomography (OCT) images showed thickening and thinning of the middle layer, while three-dimensional OCT images showed a ‘haustra coli’-like appearance. After successful balloon angioplasty, claudication completely disappeared.
Conclusions: We report a rare case of EVT successfully performed for FMD of the bilateral EIAs. Our findings suggest that OCT may provide unique diagnostic clues in FMD patients.

Keywords: Fibromuscular Dysplasia - therapy, Female, Angioplasty, Balloon, Humans, Iliac Artery, Middle Aged, Tomography, Optical Coherence