A 58-year-old man with hypertension and renal insufficiency is found to have a 'string of beads' appearance on renal artery angiography. What is the most likely underlying pathology?
- A Fibromuscular dysplasia ✓
- B Atherosclerotic renal artery stenosis
- C Polyarteritis nodosa
- D Takayasu arteritis
Correct answer: A. Fibromuscular dysplasia
Explanation
Fibromuscular dysplasia, particularly the medial fibroplasia subtype, produces the characteristic 'string of beads' appearance on angiography due to alternating areas of stenosis and aneurysm. It predominantly affects young to middle-aged women but can occur in men. Atherosclerotic stenosis is typically ostial and smooth. Polyarteritis nodosa causes microaneurysms in medium vessels, not the beaded pattern.
Reference: Rutherford's Vascular Surgery and Endovascular Therapy, 9th ed.
High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP
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