Fibromuscular Dysplasia Recommendations for Fibromuscular Dysplasia Referenced studies that support recommendations are summarized in online Data Supplement 54. COR LOE Recommendations In patients with fibromuscular dysplasia (FMD) and a history of ischemic stroke or TIA without other attributable causes, antiplatelet therapy, BP control, and lifestyle modification are recommended for the prevention of future In patients with a history of ischemic stroke or TIA attributable to dissection, with FMD, and no evidence of intraluminal thrombus, it is reasonable to administer antiplatelet therapy for the prevention of future ischemic events. In patients with cervical carotid artery FMD and recurrent ischemic stroke without other attributable causes despite optimal medical management, carotid angioplasty with or without stenting may be reasonable to prevent Synopsis FMD is a nonatherosclerotic segmental disease of small or medium-sized arteries that can result in arte- rial stenosis, occlusion, intraluminal thrombus, aneu- rysm, or dissection.752 It can involve the extracranial carotid, vertebral. and renal arteries. On a histological level, FMD affects the musculature or media layer of the vessel wall, leading to medial fibroplasia and the appearance of a string of beads on angiography imaging. Multiple fibrous webs can serve as a nidus for platelet deposition755 or obstruct flow, resulting in thromboembolic TIA or ischemic stroke. Women are more commonly affected than men. The frequency of neurological events in the US FMD registry was noted: 13.4% had TIA; 5% had experienced amaurosis fugax; 12% had experienced cervical artery dissection; and 9.8% had had a stroke.756 Recommendation-Specific Supportive Text 1. High BP is common in patients with FMD, from either essential hypertension or renovascular hypertension related to FMD.752 The optimal BP target for patients with FMD is unknown. 