دانلود رایگان مقاله ضایعات آترواسکلروتیک در شریان کاروتید در بیماران مبتلا به آنوریسم آئورت شکمی

Abstract

Atherosclerosis was considered the main cause of abdominal aorta aneurysms. Many researchers suggest the presence of the association between these two entities. The aim of this paper was to evaluate the presence of atherosclerosis in the aorta and the arteries of the lower extremities, as well as stenoses and occlusions of carotid arteries in patients with abdominal aorta aneurysm. One-hundred and eighty patients with abdominal aorta aneurysm (23 women and 157 men), aged 50e86 years old (mean 67.28
9.95) were qualified for the study. Each patient had ultrasound of abdominal aorta, arteries of the lower extremities and extracranial carotid arteries. The patients were divided into two groups: A e isolated abdominal aorta aneurysm (AAA-92 patients), B e AAA with atherosclerotic lesions in the abdominal aorta and/or the arteries of the lower extremities (88 patients), in which four different localizations of atherosclerotic lesions were distinguished. The statistically significant differences between the groups were observed in the prevalence of carotid arteries stenosis (CCA þ ICA). No correlation was found between the aneurysm diameter and the stenosis grade of the extracranial segments of the carotid arteries. The presented results confirm the common occurrence of atherosclerotic lesions in aorta and/or arteries of the lower extremities and carotid arteries in patients with abdominal aorta aneurysm, yet their etiology is different. Such patients represent a heterogeneous group in respect to the presence of carotid arteries stenoses.

Discussion Until recently atherosclerosis was considered the primary cause for the formation of abdominal aorta aneurysms.1 Commonly observed atherosclerotic plaques in the intima of aneurysmatic aorta and processes associated with their formation and evolution, such as rupture and dissection secondary to the hemorrhagic conversion may influence the natural course of aneurysm, resulting in the reduction of wall strength and raise in the risk of aneurysm rupture. One of the main phenomenon taking place during blood vessel aging is the degradation of elastic fibers, which intensifies in such conditions as atherosclerosis, arterial hypertension and diabetes.3,4 Some studies indicated the high elastase activity in human aorta extracts, which increased exponentially with age and correlated with the severity of atherosclerotic lesions. The impairment of elastin/laminin receptor function and its permanent stimulation (e.g. during aging) was proven responsible for the overproduction of elastases and elastin degradation.4 The positive correlation between the concentration of elastin degradation products and aneurysm growth rate was found.5,6 The atherosclerosis-like process that was previously considered responsible for pathological aorta dilatation was not confirmed in recent studies.