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Celeste
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(8/30/02 11:20 pm)
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From an FMD patient and researcher - Sharon
Date:        2/21/02 1:39:03 PM Eastern Standard Time
From:        sarbic@hotmail.com (Sharon Arbic)
To:        Celeste

HI SORRY IT TOOK ME SO LONG BUT I HAVE BEEN WORKING A LOT LATELY HERE IS THE BIBLIOGRAPHY FOR THE INFO I SENT YOU .

FIBROMUSCULAR DYSPLASIA OF RENAL
ARTERY : MANAGEMENT AND OUTCOME.

AUTHORS JINNI T JAGASE, ROSS R BAILEY
AND ANTONY T YOUNG. DEPARTMENT OF NEPHROLOLGY AND RADIOLOGY CHRISTCHURCH
HOSPITAL CHRISTCHURCH NEW ZEALAND.

HERE IS SOME MORE INFO FROM AN ARTICLE RENAL ARTERY FIBRODYSPLASIA AND RENOVASCULAR HYPERTENSION

AUTHORS LOUIS M MESSINA, M.D. AND JAMES C STANLEY, M.D.
TYPES 1) INITMAL FIBROPLASIA
2) MEDIAL HYPERPLASIA 3) MEDIAL FIBROPLASIA
4)PERIMEDIAL DYSPLASIA

THE FIRST TWO ARE DISTINCTLY
DIFFERENT PATHOLOGICAL PROCESSES WHILE THE LAST TWO ARE CONTINUING PATHOLOGY
OF MEDIAL FIBROPLASIA

5)DEVELOPMENTAL STENOSES
IS A RARE FORM OF FMD INTIMAL---- affects
children, and young adults of both sexes equally. In younger patients it produces long tubular irregular stenoses of the main renal artery. In older patients it produces smooth focal stenose. Progression is usually
slower than medial fibroplasia.
MEDIAL HYPERPLASIA--------- Is found in fewer than 1 % of lesions. Is mostly in women age 30-50 years. Found in the form of an isolated
lesion in the mid-portion of the renal artery. This may be the beginning
of advanced lesions of medial fibroplasia and perimedial dysplasia.
MEDIAL FIBROPLASIA Is most common in white women in the 30-50 age group, and is most common in the renal arteries. It is bilateral(both) in 55% of cases,
but if unilateral (only one) then it is usually the right renal artery in 80% of cases. It affects the distal(nearest the kidney)part of the artery and will go into the branch vessels of the kedney in 25% of the cases. This creates the string of beads everyone is talking about.
PERIMEDIAL DYSPLASIA------------- Is seen in 10% of lesions and is an accumulation of elastic tissue. It is seen in younger women whod do not have the string beads seen in medial fibroplasia.

TREATMENT

PERCUTANEOUS TRANSLUMINAL RENAL ANGIOPLASTY (PTRA) In procedure that is the same a angiography a balloon type catheter is inserted into the affected artery and the lesion is dilated 2 or 3 times. It stretches the artery wall and splits the media and stretches the adventia.

Gradually the artery heals and remains stretched. This treatment works in 85% of cases, thereby lowering the bloodpressure. It works best for unilateral lesions of medial fibroplasia.

COMPLICATIONS=======Include arterial dissection (cut) or perforation (hole). It is not used with pation that have branch disease, microanyeurisms or
complex dissections.

SURGICAL THERAPY----------Involves an incision and major surgery to graft the arteries to the larger aortic, hepatic, splenic or common iliac arteries. It involves all the risks of any other major surgery.

THATS ALL I HAVE FOR NOW WILL TRY AND GET MORE SHARON

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