Abstract
A ruptura dos vasa vasorum tem sido reconhecida como uma das causas do hematoma intramural da aorta há 90 anos. Esta breve revisão apresenta sistematicamente a fisiologia desses vasos e o seu papel na fisiopatologia das alterações parietais da aorta que ocorrem na hipertensão arterial, na arteriosclerose e na síndrome aórtica aguda. A hipótese defendida aqui é a de que a ruptura dos vasa vasorum ocorre como um fenômeno secundário e não como um dos fatores causais na fisiopatologia do hematoma intramural.
Highlights
IntroductionVasa vasorum (VV) are small arteries which penetrate the arterial wall both through the luminal surface (vasa vasorum internae) and the adventitia (vasa vasorum externae)
Vasa vasorum (VV) are small arteries which penetrate the arterial wall both through the luminal surface and the adventitia
VV seem to play a fundamental role in the physiopathology of the three acute aortic syndrome entities: aortic dissection, intramural hematoma (IMH), and penetrating ulcer
Summary
Vasa vasorum (VV) are small arteries which penetrate the arterial wall both through the luminal surface (vasa vasorum internae) and the adventitia (vasa vasorum externae). Adventitial VV ramify into smaller vessels supplying the outer media layers. Venous VV are more numerous and supply mainly the outer media. Arteries containing less than 29 cellular layers or less than 0.5 mm diameter do not present VV.[1,2]. Tridimensional study of these vessels became possible,[3,4] as well as microarteriography have enabled a more thorough understanding of their anatomy and distribution[5] through the injection of a silicone polymer (Microfil®, Flow Tech, U.S.). VV seem to play a fundamental role in the physiopathology of the three acute aortic syndrome entities: aortic dissection, intramural hematoma (IMH), and penetrating ulcer
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