Axillary artery fibromuscular dysplasia in a symptomatic type B aortic dissection causing acute limb ischemia

Fibromuscular dysplasia (FMD) can manifest outside of its classic presentation with unusual pathology. In the present report, we have described a case of an older male patient with aortic degeneration related to acute type B dissection who had required emergent left carotid–subclavian transposition and aortic stenting. Intraoperatively, his axillary artery FMD led to acute upper extremity ischemia. The patient was treated with classic maneuvers, including balloon angioplasty, reflecting the best practices in vascular surgery. We have also discussed the diagnosis, classification, and management of FMD.