10. Aortic atherosclerosis with aneurysm

Organ: Abdominal aorta

Aortic aneurysm with thrombus

Description:

Atherosclerotic plaques are visible in the whole preparation. Atherosclerosis can have a yellowish micromorphology. In the middle there are remnants of a thrombus. In the lower part the dilated portion shows an aneurysm

Diagnosis: Atherosclerosis with aneurysm

Risk factors:

• Smoking
• Hypertension
• Hypercholesteremia
• Diabetes

Theory:

Atherosclerosis is the disease where plaque builds up in your arteries. Details are in topic 9.

Because atherosclerosis always begins with endothelial injury. Smoking is a risk factor because the smoke is toxic for the endothelium. Hypertension causes physical stress and injury on the endothelium. LDL is a main component of the plaques, so hypercholesteremia will lay the groundwork for plaque formation. In diabetes the LDL receptor on the endothelium is defective so that the endothelial cells cannot take up LDL by endocytosis. This further increases the LDL levels in the blood.

Complications of atherosclerosis can be

• Thrombosis of the vessel, leading to total blockage. Thrombi form more easily on plaques than in normal vessels
• Calcification of the vessel, causing it to lose its elastic properties
• Aneurysm that can rupture and lead to haemorrhage
• Ulcer