Fibromuscular Dysplasia in Acute Type A Aortic Dissection: A Common yet Underrecognized Vascular Phenotype in Women

Fibromuscular dysplasia was confirmed in 9% (18/200; 95% CI 6–14%) of patients with acute type A aortic dissection on ECG-triggered CTA, with higher rates in women (19%).

• Why it matters: FMD is common in women but its link to acute type A aortic dissection is unclear, leaving clinicians uncertain whether this vascular phenotype is being missed.
• What they did: In a retrospective single-center cohort of 200 ATAAD patients under 70, CT angiography was reviewed for multifocal arterial beading meeting consensus criteria, with independent radiologist confirmation.
• The result: FMD was more frequent in women than men (P<0.001) and predominantly involved renal arteries, suggesting FMD is an underrecognized phenotype among ATAAD presentations.

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