Abstract
Fibromuscular dysplasia (FMD) is a non-atherosclerotic, non-inflammatory arteropathy of unknown etiology that affects small and medium sized arteries causing luminal narrowing and aneurisms. It is most common in renal arteries, but is also often observed in carotid arteries and very rarely in peripheral arteries. The present case is a 55-year-old man who smoked 20 cigarettes a day since the age of 15 and noticed ulcers and coldness in his fingers and toes. An intra-arterial angiography revealed blockage in both radial and posterior tibial arteries which led to a diagnosis of Buerger's disease. Cauterization was performed on the left thoracic sympathetic nerve and a sympathectomy was performed on the right lumbar sympathetic nerve in addition to a biopsy taken of the right posterior tibial artery. No organized clotting or venous thrombophlebitis could be observed in the pathology, so the patient was diagnosed with FMD due to hyperplasia in the tunica externa and media. The patient was given a diagnosis of Buerger's disease according to the diagnostic criteria of Shionoya but FMD was diagnosed in the peripheral arteries from the pathological findings. This case is a rare case of FMD in the peripheral arteries and was confirmed pathologically. Considering that Buerger's disease had been diagnosed before surgery, it is possible that FMD was present in some Buerger's disease cases in the past.
