Clinical History:
This 65-year-old man died from a large cerebral infarction several months after retiring from an accounting firm. For many years his only exercise consisted of daily trips to the office soft drink dispenser. At autopsy, the aorta showed 100% atherosclerosis with lipid plaques, ulcerations, mural thrombus, and calcifications. These images all show the aorta.
The aorta in images 21, 22, and 23 is stained with H&E and shows marked atherosclerosis with a thickened intima containing prominent cholesterol clefts and lipophages, focal medial degeneration, and overlying thrombus formation.
- How often does the aorta become occluded by thrombus?
Virtually never! It is too big and the flow is too great, though the bifurcation and branches may become occluded.
- How often do atheromatous emboli occur?
Despite shoving catheters in a variety of atherosclerotic arteries for the purpose of diagnostic imaging studies in many hospitalized patients, atheromatous emboli are rare (or at least of minimal clinical consequence).
- What factors accelerate atherosclerosis?
Atherosclerosis is accelerated by increased LDL cholesterol (and decreased HDL cholesterol), increased vasoactive amines, smoking.
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