Atherosclerotic Renal Artery Stenosis Mimicking Fibromuscular Dysplasia

We experienced a case with atherosclerotic renal artery (RA) stenosis mimicking fibromuscular dysplasia (FMD). In this case, renal angiography, which is considered the ‘gold standard’ for diagnosing FMD, demonstrated a typical ‘string-of-beads’ sign. However, integrated backscatter intravascular ultrasound (IB-IVUS) showed severe atherosclerotic stenosis of the RA with a large amount of lipid pool. Therefore, we decided to perform adjunctive stent implantation which is considered optimal treatment of atherosclerotic RA stenosis. Our case suggests that IVUS evaluation might be useful for an accurate diagnosis and to help develop a treatment strategy for revascularisation.