Angiologiia i sosudistaia khirurgiia = Angiology and vascular surgery · 2026
[Histological changes of the aortic wall in the area of the proximal neck of an aneurysm upon rupture].
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Khafizov T N, Kataev V V, Shumkin A M, Shchekin S V, Zagidullin B I, Manylova V R, Khafizov R R, Imaev T E
Аннотация
OBJECTIVE: To study the state of tissues of the aortic wall in the area of the proximal neck of an aneurysm in patients with lethal outcomes due to aneurysmal rupture.
MATERIALS AND METHODS: A fragment of the aortic wall for histological examination was procured from the area of the proximal neck of aneurysms in 16 patients who died from ruptured aneurysms of the abdominal and thoracic aorta. The fragment of the aortic wall to study was taken at a distance from 1 to 4 cm above the upper pole of the aneurysm. The specimens after being treated with phosphotungstic acid were stained with hematoxylin and eosin, aniline blue.
RESULTS: Damage to all layers of the aortic wall was revealed at a distance of 1 cm from the upper pole of the aneurysm. The most pronounced changes were observed in the medial layer. At a distance of 2 cm from the upper pole of the aneurysm, the aortic wall was found to contain atherosclerotic plaques circumscribed by a thick, dense layer of collagen fibers with diffuse hyalinosis. At a distance of 3 cm from the upper pole of the aneurysm, there was a decrease in the severity of the lesion of the aortic wall. At a distance of 4 cm from the upper pole of the aneurysm, in the media predominated foam cells, visualizing pronounced medial atrophy, with replacement of elastic fibers by coarse collagen fibers.
CONCLUSION: In patients with ruptured aortic aneurysms, the structural integrity of the aortic wall begins at a distance of 4 cm above the upper pole of the aneurysm, which should be taken into consideration when performing surgical treatment.
MATERIALS AND METHODS: A fragment of the aortic wall for histological examination was procured from the area of the proximal neck of aneurysms in 16 patients who died from ruptured aneurysms of the abdominal and thoracic aorta. The fragment of the aortic wall to study was taken at a distance from 1 to 4 cm above the upper pole of the aneurysm. The specimens after being treated with phosphotungstic acid were stained with hematoxylin and eosin, aniline blue.
RESULTS: Damage to all layers of the aortic wall was revealed at a distance of 1 cm from the upper pole of the aneurysm. The most pronounced changes were observed in the medial layer. At a distance of 2 cm from the upper pole of the aneurysm, the aortic wall was found to contain atherosclerotic plaques circumscribed by a thick, dense layer of collagen fibers with diffuse hyalinosis. At a distance of 3 cm from the upper pole of the aneurysm, there was a decrease in the severity of the lesion of the aortic wall. At a distance of 4 cm from the upper pole of the aneurysm, in the media predominated foam cells, visualizing pronounced medial atrophy, with replacement of elastic fibers by coarse collagen fibers.
CONCLUSION: In patients with ruptured aortic aneurysms, the structural integrity of the aortic wall begins at a distance of 4 cm above the upper pole of the aneurysm, which should be taken into consideration when performing surgical treatment.