BLOOD VESSELS

DISORDERS
ANEURYSM

BM Solomon CAC.
• Dfn. Permanent abnormal dilatation of blood
vessels ddue to congenital/acquired weakening or
destruction of vessel walls.
• Involve large arteries

• Causes the following

• Thrombosis
• Thromboembolism
• Altered blood flow
• Rupture of vessels
• Compression of neighbouring structures

CLASSIFICATION
Done in three ways.
1. Based on wall composition
a.True aneurysm -has all layers of
normalvessels
• b False aneurysm- has fifibrous wall, often
in.trauma
• 2 based on shape..
• Saccular- lage spherical outpouring
• Fusiform- slow spindle shaped dilatation
• Cylindrical-continuous parallel dilatation
• Serpentine- tortous dialations of vessels
• Racemose- having mass of intercommunicating
small arteries and vein.
• 3. Based on Pathogenesis
• A . Atherosclerotic Aneurysm
• Most common
• More in men 50+years at the abdominal aorta

• Pathogenesis
• Atherosclerotic lesion cause thinning and
destruction of medial elastic tissue, leading to
aatrophy and weakening of vessels wall.
• Morphological features
• Occur infrarenal above the bifurcation of the aorta,
extends to common illiac arteries occasionally
• Lager than 5-6cm in diameter. Fusiform in shape.
Lumen contain mural thrombus.
• Histologically
• Predominant with fibrous ttissue in the media and
adventiadventitia . Show mild inflammatory
reaction. Intima show remnants of atheromatous
plaque.
• Effects
• Rupture -due to pressure
• Compression-Compression ureters
• Arterial occocclusion..inferior mesenteric
• B .SSyphilitic (Leutic ) Aneurysm
• Occur in about 10 percent of Syphilis patients
• Causes arteritis
• Common in men 50+ YRS
• Occur in thoracic aorta.ascending part, arch .
• Causes aortic valve incompetence when it extends
to the valves
• Pathogenesis
• Iflammatory ininfiltrate around vasa vasorum
of adventitia followed by endarteritis
obliteration.
• Ischaemic injury occurs causing media
destruction
occur in the ascending aorta
Morphological Features
• Saccular in shape, 3-5cm diameter. Can be fusiform
or cylindrical
• Wrinkled intima, show tree bark appearance
• Rolling of valve leaflets is seen when aortic valves
are affected.
• Valve incompetence leads to volume overload, left
ventricle hypertrophy supervene.
• Massive heart enlargement occur..called Cor
bovinum
Histological Features
• Features of healed syphilitic aortitis seen. Fibrous
thickening with endartertitis obliterated vasa
vasorum.
• Fibrous scar ttissue extend into intima and media
• Spirochates demonstrate
• Mural thrombus found
Effects
• Rupture.. causing massive haemorrhage
• Compression.. to the trachea causes dyspnoea, to
the oesophagus causes dysphagia, to the recurrent
laryngeal nerve causing hoarseness. Vertebral and
rib erosion due to persistent pressure
• Cardiac Dysfunction.. aortic valve incompetence,
volume overload supervene. Narrowed coronary
ostia aggravate cardiac failure
Reference: Harsh Mohan textbook of pathology
THANK YOU ALL
BM SOLOMON
C.A.C