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Abstract
This study is aimed at investigating the relationship between inflammation, the number of vasa vasorum, and the presence of lipoprotein (a) [Lp(a)] in the aortic aneurysm wall, as well as the relationships of these pathological processes with the development of aneurysm wall dissection. To that end, we examined segments of aortic aneurysm wall, consisting of intima, media, and adventitia, collected from patients during aneurysm prosthetics intervention. The material was collected from 23 men and eight women aged from 33 to 69 years. Monoclonal antibodies to Lp(a), markers of monocytes and macrophages (CD68), T cells (CD3, CD4, and CD8), von Willebrand factor, endothelium NO synthase, and smooth muscle α-actin were used for morphological and morphometric investigation. The present study demonstrated that Lp(a) is not often found in biopsies of patients with thoracic aortic aneurysm. Morphological and morphometric investigation shows the connection of aortic dissection with the process of damage to its wall caused by inflammatory infiltrates, medianecroses, and the appearance of newly formed vasa vasorum in media.
Highlights
Aneurysms are defined as focal irreversible dilatations of all layers of the vessel wall that lead to an increase of the vessel diameter of at least one and a half times
Histodiagnosis of six patients showed the presence of massive inflammatory infiltrates in the aortic aneurysm wall (Figure 1A)
Based on the results presented above, we hypothesized that the presence of aneurysm, inflammation, and a high density of vasa vasorum in the arterial wall weakens it mechanically, leading to dissection
Summary
Aneurysms are defined as focal irreversible dilatations of all layers of the vessel wall that lead to an increase of the vessel diameter of at least one and a half times. Men suffer from this disease six times more often than women. Aneurysms of the thoracic aorta have different etiologies. Patients with thoracic aortic aneurysm are often subject to such serious complications as aortic dissection and rupture. It is believed that the following factors contribute to the rupture of the aorta: large diameter of the aneurysm (more than 6 cm) and the presence of hypertension. Choke suggested that the development of the delamination and subsequent rupture of the aortic aneurysm wall are largely due to the neovascularization of its wall and do not depend on the size of the inflammatory infiltrates [2]
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