Fibromuscular Dysplasia Involving the Iliac Artery and Mimicking Atresia of the Left Iliac Artery

Abstract

A 44-year-old woman was referred to the cardiology department due to experiencing heaviness in both legs during exertion and decreased ankle-brachial indexes of 0.83 and 0.78, respectively. She had a mild case of aplastic anemia. Lower extremity computed tomographic angiography (CTA) revealed a total occlusion of the left iliac artery from the bifurcation of the abdominal aorta, which was reconstructed at the level of the common femoral artery (Fig. 1A, red arrow). Atherosclerotic plaque was clearly visible at the abdominal aorta (Fig. 1B, C). However, the occluded iliac artery showed thread-like hypoplasia without any definitive atherosclerotic occlusion (Fig. 1D, red arrow). Initially, we suspected congenital atresia of the iliac artery due to the patient's hypoplastic