A 32-year-old woman with severe hypertension is found to have renal artery changes as shown in Figue 69-1. The following statement/s/ is/are true:

b. In the most common variant of this disorder, the media is infiltrated with increased collagen, fibrous connective tissue and glycosaminoglycans

d. Appropriate treatment includes percutaneous transluminal balloon angioplasty

Fibromuscular dysplasia is an abnormality of unknown etiology primarily affecting women (90%) and in the renal arteries. The carotid and iliac arteries are the next most frequently affected. Medial fibroplasia is the most common pathology with the pathological findings in answer b. Surgical treatment is indicated only for symptomatic stenoses since many asymptomatic cases exist for which the natural history is unknown. In addition to surgical procedures, balloon angioplasty of main renal artery lesions is acceptable treatment.