Figure 36

Arteriogram and schematic diagram of perimedial fibroplasia. A, Selective right renal arteriogram shows a tight stenosis in the mid portion of the renal artery with a small string of beads appearance, typical of perimedial fibroplasia. B, Schematic diagram of perimedial fibroplasia.

Perimedial fibroplasia, accounting for 10% to 25% of the fibrous renal artery diseases, is also observed almost exclusively in women. The stenotic lesion occurs in the mid and distal main renal artery or branches and may be bilateral. Angiographically, serial stenoses are observed with small beads, which are smaller in diameter than the unaffected portion of the renal artery. This highly stenotic lesion may progress to total occlusion; collateral blood vessels and renal atrophy on the involved side are frequently observed. Pathologically, the outer layer of the media varies in thickness and is densely fibrotic, producing a severe reduction in lumen diameter (panel B). Renal artery dissection and/or thrombosis are common. (Panel A from Pohl [1]; with permission.)

0 0

Post a comment