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Learn more about the Arterial Dysplasia Program

Symptoms of FMD vary depending on the arteries involved and how they are affected, including narrowing, dissections (tears) or aneurysms (artery bulges). Symptoms generally relate directly to the area being supplied by the diseased artery. For example, FMD in the renal arteries may cause high blood pressure. FMD in the carotid arteries may cause headaches (especially migraines), neck pain or pulsatile tinnitus (a swooshing sound in the ear). Some patients with FMD may have vague symptoms or no symptoms at all and are diagnosed incidentally (for example, when imaging of an artery is done for another reason and FMD is discovered).

FMD is typically diagnosed through imaging studies such as catheter-based angiography. During this procedure, a catheter is inserted into a large artery and advanced until it reaches the affected artery. This X-ray test uses special dye and a camera to view blood flow in the artery. Pressure inside the artery can also be measured via the catheter to help determine the severity of the blockage in the artery. Non-invasive procedures such as computed tomography angiography (CTA) and magnetic resonance angiography (MRA) are other techniques that may be used to diagnose FMD.

While there is no cure for fibromuscular dysplasia, patients with carotid or vertebral artery involvement are often prescribed aspirin to reduce the risk of stroke. Blood pressure medication helps control high blood pressure in patients with renal artery FMD. Endovascular or surgical repair of the affected artery may also be recommended to improve blood flow.

Endovascular Treatment

Balloon angioplasty is often recommended for patients with renal artery FMD who have uncontrollable blood pressure, cannot tolerate medication or have declining kidney function. 

During this procedure, which widens the affected artery and improves blood flow, a balloon is inserted through a catheter into a large artery in the groin and advanced to the affected artery. The balloon is inflated to open the impaired artery. In some cases, angioplasty may also be performed in patients with carotid or vertebral artery FMD who have severe neurological symptoms. 

For symptomatic patients with carotid or vertebral artery FMD who have suffered a dissection, angioplasty with placement of a stent may be performed. Aneurysms in the arteries of the brain may be treated by catheter-based therapies such as coiling to seal off the artery bulge. During the procedure, a catheter is inserted into a large artery in the groin and fed through the artery to the affected area of the brain. A small device known as a coil is then placed in the aneurysm to prevent blood from flowing into it.

Surgical Treatment

For patients who are not candidates for angioplasty, surgery may be necessary to repair the narrowed portion of the artery. In some cases, the renal artery may be replaced or bypassed with a vein from the leg.