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Non-atheromatous arteriosclerosis: causes, symptoms, diagnosis, treatment
Last reviewed: 23.04.2024
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Non-atheromatous arteriosclerosis is the age-related fibrosis of the aorta and its major branches.
Non-atheromatous arteriosclerosis causes a thickening of the intima and weakens and destroys the elastic components. The smooth muscle layer (middle choroid) is atrophied, and the lumen of the affected artery expands (ectasia occurs), leading to the development of an aneurysm or stratification. Arterial hypertension is a major factor in the development of aortic arteriosclerosis and aneurysms. Damage to the intima, ectasia and ulceration can lead to thrombosis, embolism, or to complete the occlusion of the artery.
Arteriolosclerosis affects the distal arteries in patients with diabetes mellitus or arterial hypertension. Hyaline arteriosclerosis affects small arteries and arterioles in diabetes mellitus. Usually a hyaline thickening occurs, the arteriolar wall degrades, and the lumen narrows, causing diffuse ischemia, especially in the kidneys. Hyperplastic arteriosclerosis develops more often in patients with arterial hypertension; typical is the development of an extended concentric thickening and narrowing of the lumen, sometimes with deposits of fibrin and necrosis of the vascular wall (necrotizing arteriolitis). Arterial hypertension increases these changes, and arteriosclerosis (due to increased arteriolar rigidity and increased peripheral resistance) can help maintain hypertension.
Arteriosclerosis of Menkeberg (calcifying sclerosis of the middle choroid) develops in patients older than 50 years. Age degeneration of the middle choroid occurs with foci of calcification and even the formation of bone tissue within the arterial wall. Sections of the artery can become a hard calcified tube without narrowing the lumen.
The diagnosis usually becomes obvious with a simple X-ray study. The clinical significance of this disease lies only in the fact that the artery is not capable of reacting with a change in the lumen, which leads to a pronounced but false increase in the BP numbers when it changes.
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