ARTERIAL DISEASES

Dr. Padmini Wijenayake

 Anatomical structure description

Arterial diseases
- Arteriosclerosis
- Atherosclerosis
- Diabetic Macro,
Microangiopathy
- Vasculitis

Pathological Process
Atherosclerosis is thickening and loss of elasticity of arterial
walls

3 Patterns with different pathophysiology and consequences:

1. Atherosclerosis
2. Monckeberg medial calcific sclerosis
>50 years - calcific deposits in muscular arteries
3. Arteriosclerosis affecting small arteries and arterioles
- 2 variants - Hyaline
- Hyperplastic
Thickening of vessel walls with luminal narrowing
Most often associated with hypertension and diabetes

Vasculitis
Inflammation of blood vessels
Syphilitic Arteritis (Tertiary Syphilis)
Ascending Thoracic aorta is maximally affected
Vasavasorum Inflammation and luminal narrowing
intimal fibrosis ( Endarteritis Obliterans)
leads to degeneration - fibrosis of aortic media
- fibrous thickening of intima
weakening of aortic wall dilatation of root and valve
interface
aneurysm formation
coronary ostial stenosis

Giant cell arteritis

- Superficial temporal artery
- intracranial arteries
granulomatous inflammation and presence of giant cells

Polyarteritis nodosa (PAN)

- frequent in young adults
- male > female
- medium and small sized arteries are involved
- type 3 hypersensitivity reaction seen
- segmental lesions
- multiple microaneurysms
- results in rupture
haemorrage
ischaemia
- Acute and chronic phases
Acute - fibrinoid necrosis of media
Chronic concentric fibrosis

both lesions coexist

involved

and symptoms depend on the organ

Kawasaki disease
Rare
seen in children
believed to be due to immunologic hypersensitivity

Burgers disease (Thrombangitis obliterans)

seen commonly in young males (20-30 yrs)
commonly in cigarette smokers
small and medium sized arteries are involved
mainly in lower extremities
lesions frequently involves adjacent veins and nerves
Acute phase - swelling and neutrophil infiltration of entire neurovascular
bundle
- Thrombosis
- healing by fibrosis and organization of thrombus
clinical presentation - Ischaemia of lower limb
- Intermittent claudication
- calf pain