Fibromuscular dysplasia of the brachial artery: A case report and review of the literature

• Published in: Journal of vascular surgery Vol. 16; no. 1; pp. 66 - 70
• Main Authors: Lin, William W., McGee, Gregory S., Patterson, Bruce K., Yao, James S.T., Pearce, William H.
• Format: Journal Article
• Language: English
• Published: New York, NY Mosby, Inc 01-07-1992; Elsevier
• Subjects: Aged; Biological and medical sciences; Blood and lymphatic vessels; Brachial Artery - pathology; Cardiology. Vascular system; Diseases of the peripheral vessels. Diseases of the vena cava. Miscellaneous; Female; Fibromuscular Dysplasia - pathology; Humans; Medical sciences; Vascular disease; Case study; Human; Arteriopathy; Brachial artery; Finger; Cardiovascular disease; Complication; Upper limb; Fibromuscular hyperplasia; Embolism
• ISSN: 0741-5214; 1097-6809
• DOI: 10.1016/0741-5214(92)90419-9

Fibromuscular dysplasia is a nonatherosclerotic, noninflammatory vascular disease that involves primarily medium-sized and small arteries. Fibromuscular dysplasia is characterized by medial fibrosis with or without smooth muscle cell hyperplasia and may produce luminal impingement with severe turbulence. Secondary aneurysmal deformity with or without thrombosis may also contribute to the obstruction. Fibromuscular dysplasia most commonly involves the renal and carotid arteries, with upper-extremity disease rarely reported. This case report describes a patient with digital embolization from brachial artery fibromuscular dysplasia. Angiography demonstrated significant narrowing and irregularity with a characteristic “string-of-beads” appearance of the right midbrachial artery. The abnormal segment was resected and reconstructed with a reversed saphenous vein graft. Histologic studies revealed disruption of the internal elastic lamina and disorientation of the hyperplastic medial smooth muscle cells characteristic of fibromuscular dysplasia.