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European consensus on the diagnosis and management of fibromuscular dysplasia

Persu, Alexandrea,b; Giavarini, Alessandrac,d; Touzé, Emmanuele; Januszewicz, Andrzejf; Sapoval, Marcg,h; Azizi, Michelc,h; Barral, Xavieri; Jeunemaitre, Xavierh,j; Morganti, Albertod; Plouin, Pierre-Françoisc,h; de Leeuw, Peterk

doi: 10.1097/HJH.0000000000000213
Guidelines and Consensus Document

The main objectives of this expert consensus are to raise awareness about fibromuscular dysplasia, which is more frequent and more often systemic than previously thought and can sometimes have devastating consequences; to provide up-to-date recommendations for the diagnosis, evaluation, and management of the disease; and to identify research priorities. The emphasis has been put on recommendations for daily practice. The main topics covered include definition, classification, diagnosis, and management of fibromuscular dysplasia in adult patients with symptomatic involvement of the renal arteries, supra-aortic trunks, and digestive and peripheral arteries.

aPole of Cardiovascular Research, Institut de Recherche Expérimentale et Clinique, Université Catholique de Louvain

bDivision of Cardiology, Cliniques Universitaires Saint-Luc, Université Catholique de Louvain, Brussels, Belgium

cAssistance Publique – Hôpitaux de Paris, Hôpital Européen Georges Pompidou, Hypertension Unit, Paris, France

dDepartment of Internal Medicine and Hypertension Center, San Giuseppe Hospital, University of Milan, Milan, Italy

eUniversité Caen Basse Normandie, Inserm U919, CHU Côte de Nacre, Caen, France

fDepartment of Hypertension, Institute of Cardiology, Warsaw, Poland

gAssistance Publique – Hôpitaux de Paris, Hôpital Européen Georges Pompidou, Interventional Radiology Unit, Paris

hUniversité Paris-Descartes, Paris Sorbonne Cité, Paris

iDepartment of Vascular Surgery, CHU Hôpital Nord, Saint-Etienne

jINSERM, U970, PARCC, Paris, France

kDepartment of Medicine, University Hospital Maastricht, Maastricht, The Netherlands

Correspondence to Professor Pierre-François Plouin, Hôpital Européen Georges Pompidou, 20 Rue Leblanc, 75908 Paris, Cedex 15, France. Tel: +33 1 56 09 30 69; fax: +33 1 56 09 20 40; e-mail:

Abbreviations: AHA, American Heart Association; CTA, CT-angiography; DSA, digital subtraction angiography; DUS, renal duplex ultrasound; FMD, fibromuscular dysplasia; HTN, hypertension; MRA, MR-angiography; PTA, percutaneous transluminal angioplasty; RAS, renal artery stenosis; SAH, subarachnoid hemorrhage; SCAD, spontaneous coronary artery dissection

Received 12 February, 2014

Revised 18 March, 2014

Accepted 18 March, 2014

© 2014 Wolters Kluwer Health | Lippincott Williams & Wilkins