{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,11]],"date-time":"2026-03-11T22:40:30Z","timestamp":1773268830678,"version":"3.50.1"},"reference-count":23,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,3,11]],"date-time":"2026-03-11T00:00:00Z","timestamp":1773187200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Surg."],"abstract":"<jats:p>We report an unusual case of fibromuscular dysplasia (FMD) with multisite involvement into the intracranial, carotid, vertebral, internal mammary, visceral, renal, iliac, axillary, and upper extremity arteries in a 30-year-old woman. The patient presented with a spontaneous rupture of a renal artery aneurysm and an expanding axillary artery pseudoaneurysm. The diagnosis of the multifocal FMD was based mostly on the classical strings-of-beads angiographic appearance of the upper extremity, visceral, vertebral, carotid, and internal mammary arteries. A coil embolization procedure was successfully performed to treat the ruptured renal aneurysm. In addition, open surgical repair of the pseudoaneurysm was uneventfully achieved using direct arterial suture. Unfortunately, the patient suffered from recurrent intraperitoneal hemorrhage, declined further endovascular interventional or open surgical procedures, and eventually died from hemorrhagic shock and multiple organ failure. To our knowledge, this is the first case in the literature describing a rare and severe FMD involving multiple arterial beds in the regions of the head, neck, chest, abdomen, and pelvis, which adversely caused renal artery aneurysm rupture, axillary artery pseudoaneurysm, and catastrophic intraperitoneal hemorrhage.<\/jats:p>","DOI":"10.3389\/fsurg.2026.1732288","type":"journal-article","created":{"date-parts":[[2026,3,11]],"date-time":"2026-03-11T06:52:42Z","timestamp":1773211962000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Case Report: Renal artery aneurysm rupture, axillary artery pseudoaneurysm, and catastrophic intraperitoneal hemorrhage caused by fibromuscular dysplasia with the involvement of multiple arterial beds"],"prefix":"10.3389","volume":"13","author":[{"given":"Haihua","family":"Zhou","sequence":"first","affiliation":[{"name":"Department of Vascular Surgery, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology","place":["Wuhan, China"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Shi","family":"Sheng","sequence":"additional","affiliation":[{"name":"Department of Vascular Surgery, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology","place":["Wuhan, China"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yun","family":"You","sequence":"additional","affiliation":[{"name":"Department of Vascular Surgery, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology","place":["Wuhan, China"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jian","family":"Wang","sequence":"additional","affiliation":[{"name":"Department of Vascular Surgery, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology","place":["Wuhan, China"]}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1965","published-online":{"date-parts":[[2026,3,11]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","first-page":"580","DOI":"10.1016\/j.pcad.2018.03.001","article-title":"Fibromuscular dysplasia: contemporary concepts and future directions","volume":"60","author":"Narula","year":"2018","journal-title":"Prog Cardiovasc Dis"},{"key":"B2","doi-asserted-by":"publisher","first-page":"e2","DOI":"10.1056\/NEJMicm1602931","article-title":"Fibromuscular dysplasia of the brachial artery","volume":"376","author":"Miller","year":"2017","journal-title":"N Engl J Med"},{"key":"B3","doi-asserted-by":"publisher","first-page":"161","DOI":"10.1016\/S0025-6196(25)07656-6","article-title":"Pathologic classification of renal arterial disease in renovascular hypertension","volume":"46","author":"Harrison","year":"1971","journal-title":"Mayo Clin Proc"},{"key":"B4","doi-asserted-by":"publisher","first-page":"1048","DOI":"10.1161\/01.cir.0000442577.96802.8c","article-title":"Fibromuscular dysplasia: state of the science and critical unanswered questions: a scientific statement from the American Heart Association","volume":"129","author":"Olin","year":"2014","journal-title":"Circulation"},{"key":"B5","doi-asserted-by":"publisher","first-page":"225","DOI":"10.1212\/CPJ.0000000000000339","article-title":"Cerebrovascular fibromuscular dysplasia: the MGH cohort and literature review","volume":"7","author":"Harriott","year":"2017","journal-title":"Neurol Clin Pract"},{"key":"B6","doi-asserted-by":"publisher","first-page":"2298","DOI":"10.1016\/S0140-6736(18)32532-7","article-title":"Kidneys are key in secondary hypertension: a case of fibromuscular dysplasia","volume":"392","author":"Oliva-Damaso","year":"2018","journal-title":"Lancet"},{"key":"B7","doi-asserted-by":"publisher","first-page":"OD08-9","DOI":"10.7860\/JCDR\/2016\/20069.7938","article-title":"Resistant hypertension due to fibromuscular dysplasia in a young male: a rare case report","volume":"10","author":"Vakili","year":"2016","journal-title":"J Clin Diagn Res"},{"key":"B8","doi-asserted-by":"publisher","first-page":"722","DOI":"10.1177\/0003319716682121","article-title":"Lower extremity fibromuscular dysplasia: clinical manifestations, diagnostic testing, and approach to management","volume":"68","author":"Brinza","year":"2017","journal-title":"Angiology"},{"key":"B9","doi-asserted-by":"publisher","first-page":"554","DOI":"10.1016\/j.jvs.2017.02.049","article-title":"Presentation, clinical features, and results of intervention in upper extremity fibromuscular dysplasia","volume":"66","author":"Nguyen","year":"2017","journal-title":"J Vasc Surg"},{"key":"B10","doi-asserted-by":"publisher","first-page":"2324709618762585","DOI":"10.1177\/2324709618762585","article-title":"Renal artery rupture in association with fibromuscular dysplasia","volume":"6","author":"Akel","year":"2018","journal-title":"J Investig Med High Impact Case Rep"},{"key":"B11","doi-asserted-by":"publisher","first-page":"e5","DOI":"10.1016\/j.avsg.2008.04.015","article-title":"Multiple aneurysms of the splenic artery caused by fibromuscular dysplasia","volume":"23","author":"Watada","year":"2009","journal-title":"Ann Vasc Surg"},{"key":"B12","doi-asserted-by":"publisher","first-page":"170","DOI":"10.1177\/1358863X15619242","article-title":"Images in vascular medicine. Visceral fibromuscular dysplasia in a patient with chronic abdominal pain","volume":"21","author":"Erwin","year":"2016","journal-title":"Vasc Med"},{"key":"B13","doi-asserted-by":"publisher","first-page":"1169","DOI":"10.1016\/j.amjcard.2018.12.045","article-title":"Prevalence, presentation, and associated conditions of patients with fibromuscular dysplasia","volume":"123","author":"Krittanawong","year":"2019","journal-title":"Am J Cardiol"},{"key":"B14","doi-asserted-by":"publisher","first-page":"bcr2014208717","DOI":"10.1136\/bcr-2014-208717","article-title":"Takayasu\u2019s or tuberculous arteritis?","volume":"2015","author":"Moura","year":"2015","journal-title":"BMJ Case Rep"},{"key":"B15","doi-asserted-by":"publisher","first-page":"153","DOI":"10.4103\/2249-4863.214978","article-title":"Aortoarteritis with tuberculosis","volume":"6","author":"Goyal","year":"2017","journal-title":"J Family Med Prim Care"},{"key":"B16","doi-asserted-by":"publisher","first-page":"241","DOI":"10.1055\/s-0034-1396931","article-title":"Fibromuscular dysplasia of renal and carotid arteries","volume":"24","author":"Jahnlova","year":"2015","journal-title":"Int J Angiol"},{"key":"B17","first-page":"12","article-title":"Carotid and vertebral arterial fibromuscular dysplasia masquerading as severe preeclampsia: a case report","volume":"107","author":"Dawley","year":"2011","journal-title":"W V Med J"},{"key":"B18","doi-asserted-by":"publisher","first-page":"119","DOI":"10.1016\/j.jocn.2017.04.003","article-title":"Isolated intracranial fibromuscular dysplasia of the posterior cerebral artery","volume":"43","author":"Yeo","year":"2017","journal-title":"J Clin Neurosci"},{"key":"B19","doi-asserted-by":"publisher","first-page":"255.e1","DOI":"10.1016\/j.avsg.2009.05.012","article-title":"Brachial artery fibromuscular dysplasia","volume":"24","author":"Rice","year":"2010","journal-title":"Ann Vasc Surg"},{"key":"B20","doi-asserted-by":"publisher","first-page":"253.e7","DOI":"10.1016\/j.avsg.2017.10.028","article-title":"Right subclavian artery aneurysms with fibromuscular dysplasia","volume":"48","author":"Kaneyuki","year":"2018","journal-title":"Ann Vasc Surg"},{"key":"B21","doi-asserted-by":"publisher","first-page":"107628","DOI":"10.1016\/j.carpath.2024.107628","article-title":"Fibromuscular dysplasia of subclavian artery: a case report and mini-review","volume":"71","author":"Stejskal","year":"2024","journal-title":"Cardiovasc Pathol"},{"key":"B22","doi-asserted-by":"publisher","first-page":"1589","DOI":"10.1016\/j.jvs.2008.06.032","article-title":"Hypoplasia and fibromuscular dysplasia of infrarenal abdominal aorta with downstream aneurysm: case report and review of the literature","volume":"48","author":"Odero","year":"2008","journal-title":"J Vasc Surg"},{"key":"B23","doi-asserted-by":"publisher","first-page":"e8896","DOI":"10.1097\/MD.0000000000008896","article-title":"A rare case report of bilateral common and internal iliac arterial fibromuscular dysplasia: coexisted dissection, aneurysm, and stenosis","volume":"96","author":"Fan","year":"2017","journal-title":"Medicine (Baltimore)"}],"container-title":["Frontiers in Surgery"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fsurg.2026.1732288\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,3,11]],"date-time":"2026-03-11T06:52:49Z","timestamp":1773211969000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fsurg.2026.1732288\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,3,11]]},"references-count":23,"alternative-id":["10.3389\/fsurg.2026.1732288"],"URL":"https:\/\/doi.org\/10.3389\/fsurg.2026.1732288","relation":{},"ISSN":["2296-875X"],"issn-type":[{"value":"2296-875X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,3,11]]},"article-number":"1732288"}}