Iliac artery fibromuscular dysplasia successfully treated by balloon angioplasty guided by intravascular ultrasound and pressure wire measurements: A case report

A 71-year-old woman was admitted with a 6-month history of lower limb intermittent claudication. She had well-controlled hypertension and no other risk factor of atherosclerosis. Angiographic findings revealed the “string of beads” pattern in bilateral renal arteries and external iliac arteries. She was diagnosed with combined renal and iliac fibromuscular dysplasia (FMD) and underwent balloon angioplasty for bilateral external iliac arteries. Angiography did not accurately show the severity of stenosis and the location of intraluminal obstruction. In contrast, intravascular ultrasound (IVUS) with pressure gradient measurements using a wire clearly identified the primary site of stenosis and determined the treatment efficiency. In conclusion, FMD of the external iliac arteries was successfully treated by balloon angioplasty guided by IVUS and pressure wire measurements.