Schmitz F, Langkau G, Müller K M
Institut für Pathologie, Berufsgenossenschaftliche Kliniken Bergmannsheil, Universitätsklinik, Bürkel-de-la-Camp-Platz 1, 44789 Bochum, Germany.
Pathologe. 2004 Mar;25(2):120-6. doi: 10.1007/s00292-003-0675-0.
Until now the causal and formal pathogenesis of the inflammatory aortic aneurysm is poorly known. This report shows the pathological- anatomical findings of surgical and autoptical preparations, on the one hand 78 months and on the other hand 82 months, after vascular-prosthetical treatment of inflammatory aneurysms in the abdominal and thoracal part of the aorta. By morphological studies it was possible to reveal, the over years existing disease, the typical picture of inflammatory aneurysm, focal destruction of the genuine aortic wall and partial substitution by inflammatory-fibrous, less qualitative granulation tissue. Even 6 1/2 years past the implantation of the Dacron-prosthesis, there is still no complete ingrown. In addition to the known findings of the transprosthetical organization with a variable development of the outer connective-tissued coat and neointima, the incorporated granulation-tissue was overlapped by a strong inflammation according to the basic disease. In several parts of the inflammatory destructed aortic wall, there is still no fixed incorporation of the prosthesis after 7 years, so that "hypermobile-prosthetic-parts" can be found as a result.
迄今为止,炎性主动脉瘤的病因及形态学发病机制仍鲜为人知。本报告展示了在对腹主动脉和胸主动脉的炎性动脉瘤进行血管假体治疗后,分别于78个月和82个月进行手术及尸检标本的病理解剖学发现。通过形态学研究得以揭示,多年来存在的疾病、炎性动脉瘤的典型表现、真性主动脉壁的局灶性破坏以及被炎性纤维性、质量较低的肉芽组织部分替代的情况。即使在植入涤纶假体6年半后,仍未完全长入。除了已知的假体周围组织形成情况以及外层结缔组织包膜和新内膜的不同发展外,根据基础疾病,植入的肉芽组织被强烈炎症所覆盖。在炎性破坏的主动脉壁的几个部位,7年后假体仍未牢固植入,因此会出现“假体活动过度部分”。