Perry M O
J Cardiovasc Surg (Torino). 1982 Jan-Feb;23(1):54-8.
Focal lesions in the renal artery caused by fibromuscular dysplasia (FMD) are susceptible to spontaneous intramural dissection, and carry a serious risk of malignant hypertension and loss of renal function. Of four patients with arterial dissection and severe hypertension, nephrectomy was required in two, an aortorenal bypass was constructed in one, and spontaneous re-entry with resolution of malignant hypertension occurred in one man. All except the patient with re-entry became normotensive. Isolated dissections in the renal artery wall in association with FMD apparently occur more often than previously suspected. Since extensive distal dissection may preclude repair, the identification and early surgical treatment of these lesions are important features in managing these patients.
由纤维肌发育异常（FMD）引起的肾动脉局灶性病变易发生自发性壁内剥离，并伴有恶性高血压和肾功能丧失的严重风险。在4例动脉剥离和严重高血压患者中，2例需要进行肾切除术，1例进行了主动脉-肾动脉搭桥术，1例男性患者出现自发性再通且恶性高血压消退。除再通患者外，所有患者血压均恢复正常。与FMD相关的肾动脉壁孤立性剥离显然比以前怀疑的更为常见。由于广泛的远端剥离可能无法进行修复，因此识别和早期手术治疗这些病变是管理这些患者的重要环节。
