How is Fibromuscular Dysplasia treated?
There is no cure for FMD. However, many of the bothersome signs and symptoms can be effectively treated. In some cases an attempt should be made to improve the flow of blood through a vessel that is narrowed due to FMD. The kind of treatment used depends largely upon which arteries are affected, the type of FMD, the severity of symptoms and whether the artery is narrowed or enlarged. The experience and expertise available at your medical institution will also play an important role in what treatment options are available to you.
If your health care professionals feel that treatment is warranted, most often percutaneous transluminal angioplasty (PTA or “balloon angioplasty”) is preferred. Balloon angioplasty is often performed at the same time as an arteriogram. Arteriography is a procedure that is performed by a specialist in vascular diseases that involves inserting a catheter (tube) into or near the affected artery and injecting contrast material. An x-ray of the affected area is then taken and examined. If an angioplasty is performed, a catheter is extended onto the affected artery and a small balloon is inflated that “stretches” open the artery by disrupting the multiple webs (beads) that occur. A stent is typically not required to keep the vessel open unless a dissection or tear in the artery is present or occurs during the procedure. The individual is usually awake for the procedure although medications may be given to sedate the patient and make her/him more comfortable. This outpatient procedure usually lasts from one to two hours with a recovery period of up to six hours (this varies widely).
Under most conditions surgery is only required if there is an aneurysm present. Most patients are asked to take aspirin or another anti-platelet medication daily. This will help prevent the platelets from sticking to the wall of the artery. Patients with FMD may be prescribed blood pressure lowering medications and or medications to treat high cholesterol. All patients who use tobacco should be encouraged to quit. The appropriate treatment will vary with each individual and severity of the disease. It should be discussed in depth with a specialist who is very knowledgeable about FMD and its natural history.