Progressive fibromuscular dysplasia of the renal artery. Angiographic and clinical follow-up.

Eight patients with unilateral and 12 patients with bilateral fibromuscular dysplasia of the renal arteries were re-examined after 3 to 11 (mean 6) years. Angiographic progression was evaluated in a score system and occurred in 19 of the 20 patients, 83 per cent had progression on the right and 54 per cent on the left side. The most frequent indications of progressive disorder were increase in the length of the lesion and the number of membraneous stenoses. Less sensitive was the determination of least luminal diameter, mainly due to difficulties in measuring this in the majority of cases. Nine of the patients had clinical progression of hypertension. These patients did not differ in angiographic score from the 11 without such progression. Because of the progressive nature of the disease and the existing problems to evaluate the hemodynamic significance of fibromuscular dysplasia, a frequent use of percutaneous transluminal angioplasty is recommended.