Jeffrey W Olin, DO, Professor of Medicine at the Icahn School of Medicine at Mount Sinai, discusses the “string of beads” as the description typically given to the appearance of the renal artery in fibromuscular dysplasia (FMD). It was originally described from its appearances on digital angiography, but is equally well seen on contemporary CTA and MRA. It is also referred to as the string of pearls.
FMD is one of the renovascular causes of secondary hypertension, while SAM is the most common cause of spontaneous intraperitoneal or mesenteric hemorrhage in the middle-aged and elderly.
Fibromuscular dysplasia (FMD) is a rare condition characterized by abnormal development or growth of cells in the walls of blood vessels (arteries) that can cause the vessels to narrow. The carotid arteries, which pass through the neck and supply blood to the brain, are commonly affected. Arteries within the brain and kidneys can also be affected. Some people with FMD experience no symptoms of the disease while others may experience high blood pressure, dizziness or vertigo, chronic headache, ringing in the ears, weakness or numbness in the face, neck pain, or changes in vision. Potential severe complications include arterial aneurysms and dissections, stroke, subarachnoid hemorrhage (when a brain aneurysm ruptures), and mesenteric ischemia.
FMD is most often seen in people age 25 to 50 years and affects women more often than men. The cause of FMD is unknown, however, genetic and hormonal factors may be involved. Familial cases of FMD are rare. Treatment is based on the arteries affected and the progression and severity of the disease.
