Whole-body CT angiography identified new arterial lesions in 48.3% of patients overall, with higher detection rates in SCAD (64.3%) and DAAD (62.2%) subgroups compared to FMD (36.3%).
Observational (n=145)
No
Does whole-body CT angiography identify additional arterial lesions in patients with FMD, SCAD, or DAAD?
Whole-body CT angiography identifies new arterial lesions in nearly half of patients with FMD, SCAD, or DAAD, supporting systematic screening in these populations.
Objective: Guidelines recommend to perform Brain-to-Pelvis CT angiography (CTA) both in patients with fibromuscular dysplasia (FMD) and spontaneous coronary artery dissection (SCAD), whatever the clinical presentation, in order to identify additional FMD-lesions, aneurysms or dissections. However, the diagnostic yield of this approach remains unclear. Furthermore, whether such screening is also warranted in patients <60 years with unexplained dissection or aneurysm - i.e. with so-called “dissecting or aneurysmal multisite arterial disease” (DAAD) - remains to be investigated. Design and method: We aimed to evaluate the prevalence and nature of additional arterial lesions identified by whole-body CTA in 145 patients consecutively enrolled in the European/International Fibromuscular Dysplasia Registry and Initiative (FEIRI) between 2015 and 2025 at the Cliniques Universitaires Saint-Luc (Brussels, Belgium). Patients were categorized as FMD, SCAD, or DAAD, according to initial clinical presentation. Results: The mean age at diagnosis of patients with FMD (n = 80), SCAD (n = 28), and DAAD (n = 37) was 49.0 ± 14.4; 48.1 ± 10.8; and 44.35 ± 10.7 years, respectively. The proportion of women in each subset was 88.8%, 92.9%, and 67.6%. Systematic CTA allowed to identify one or more new arterial lesions in 48.3% (n=70) of patients overall, with higher detection rates in SCAD (64.3%) and DAAD (62.2%) subgroups compared to FMD (36.3%). Detected lesions were predominantly string of beads (88.6%), followed by aneurysms (24.3%) and dissections (21.4%). Patients with an initial cerebrovascular presentation had higher detection rates compared to those with renovascular presentation (58.3% vs. 36.8%). Conclusions: Our results support the current recommendation to perform a systematic screening for arterial lesions in patients with FMD and SCAD. Furthermore, the prevalence of newly diagnosed lesions in DAAD patients was nearly twice that observed in FMD. If confirmed in larger multicenter cohorts, these findings would justify extending systematic CT screening to patients with DAAD.
Robberechts et al. (Fri,) conducted a observational in Fibromuscular dysplasia, spontaneous coronary artery dissection, or dissecting/aneurysmal disease (n=145). Whole-body CT angiography was evaluated on Identification of one or more new arterial lesions. Whole-body CT angiography identified new arterial lesions in 48.3% of patients overall, with higher detection rates in SCAD (64.3%) and DAAD (62.2%) subgroups compared to FMD (36.3%).