What are the potential complications of Fibromuscular Dysplasia that I should be aware of in my practice?

Potential complications of fibromuscular dysplasia (FMD) to be aware of in clinical practice include:

• Arterial stenosis and ischemia: FMD commonly causes arterial stenosis, which can lead to reduced blood flow and ischemic symptoms depending on the affected vascular bed, such as renal artery stenosis causing hypertension or cerebrovascular ischemia causing neurological symptoms Persu et al. 2016.
• Arterial dissection: Spontaneous arterial dissection is a recognized complication, particularly in the carotid and vertebral arteries, which can result in stroke or transient ischemic attacks Persu et al. 2016.
• Aneurysm formation and rupture: FMD predisposes to aneurysm development, especially intracranial aneurysms, which carry a risk of rupture leading to subarachnoid hemorrhage, a life-threatening event requiring urgent management NICE NG228.
• Hypertension: Secondary hypertension is a frequent complication due to renal artery involvement, which may be resistant to standard antihypertensive therapy and requires targeted vascular assessment and management Persu et al. 2016.
• Vascular occlusion and thrombosis: Progressive arterial narrowing or dissection can lead to occlusion and thrombosis, further compromising organ perfusion Persu et al. 2016.

In summary, the main complications of FMD include arterial stenosis causing ischemia, arterial dissection, aneurysm formation with risk of rupture, secondary hypertension, and vascular occlusion. Awareness of these complications is critical for timely diagnosis and management to prevent serious outcomes such as stroke or subarachnoid hemorrhage NICE NG228 Persu et al. 2016.