Vascular diseases: aortitis, aortic aneurysms, and vascular calcification

• Published in: Cardiovascular pathology Vol. 25; no. 5; pp. 432 - 441
• Main Authors: Ladich, Elena, MD, Yahagi, Kazuyuki, MD, Romero, Maria E., MD, Virmani, Renu, MD
• Format: Journal Article
• Language: English
• Published: United States Elsevier Inc 01.09.2016
• Subjects: Aortic Aneurysm - pathology; Aortic aneurysms; Aortic Valve - pathology; Aortitis; Aortitis - pathology; Calcification; Humans; Pathology; Vascular Calcification - pathology; Calcification; Aortitis; Aortic aneurysms
• ISSN: 1054-8807; 1879-1336
• DOI: 10.1016/j.carpath.2016.07.002

Abstract Inflammatory diseases of the aorta broadly include non-infectious and infectious aortitis, periaortitis, atherosclerosis, and inflammatory atherosclerotic aneurysms. Aortitis is uncommon but is increasingly recognized as an important cause of aortic aneurysms and dissections. Abdominal (AAA) and thoracic aortic aneurysms (TAA) have different pathologies and etiologies. AAAs are the most common type of aortic aneurysm and the vast majority of these are atherosclerotic. The causes of TAA vary depending on the site of involvement but medial degeneration is a common pathologic substrate, regardless of etiology, and genetic influences play a prominent role in TAA expression. Standardized classification schemes for inflammatory and degenerative diseases of the aorta have only recently been added to the pathology literature. A brief overview of the new histopathologic classifications for aortic inflammatory and degenerative diseases has recently been published by the Society for Cardiovascular Pathology and the Association for European Cardiovascular Pathology as a consensus documents on the surgical pathology of the aorta. Vascular calcification is a highly regulated biologic process and the mechanisms leading to vascular calcification are under investigation. Calcification may occur in the intima (atherosclerotic) or in the media secondary to metabolic disease. Rarely, vascular calcification may be associated with genetic disorders.