Department of Pathology, University Medical Center Utrecht, Utrecht, The Netherlands.
Department of Radiology, University Medical Center, Utrecht, The Netherlands.
Clin Anat. 2021 Sep;34(6):835-841. doi: 10.1002/ca.23701. Epub 2020 Nov 20.
Although arteries of the leg have been studied in extensively diseased amputation specimens, little is known about the composition of vascular lesions present in the general population. The aim of this study was to describe the natural development of adaptive intimal thickening, atherosclerotic lesion development and vascular calcification in the leg of a general elderly population.
Two hundred and seventy postmortem samples from the popliteal and posterior tibial arteries of 14 elderly cadavers were studied histologically.
Atherosclerotic lesions were more frequently observed in the popliteal (60%) than in the posterior tibial artery (34%; p < .0005). These atherosclerotic plaques were most often nonatheromatous (80% and 83% for popliteal and posterior tibial plaques, respectively). The atheroma's that were present were small (most <25% of plaque area). Atherosclerotic plaque calcification was observed more often in the popliteal (39%) than in the posterior tibial samples (17%; p < .0005). Medial arterial calcification was observed more often in the posterior tibial (62%) than in the popliteal samples (46%; p = .008). Plaque calcification and medial arterial calcification were not associated with lumen stenosis.
In the leg of elderly cadavers, the presence of atherosclerotic plaque and intimal calcification decreases from the proximal popliteal artery to the more distal posterior tibial artery and most atherosclerotic lesions are of the fibrous nonatheromatous type. In contrast, the presence and severity of medial calcification increases from proximal to distal.
尽管腿部动脉在广泛患病的截肢标本中已被广泛研究，但对于普通人群中存在的血管病变的组成知之甚少。本研究旨在描述适应性内膜增厚、动脉粥样硬化病变发展和下肢血管钙化在普通老年人群中的自然发生情况。
研究了 14 具老年尸体的 270 个后腘窝和后胫后动脉的组织学样本。
在后腘窝动脉（60%）中观察到的动脉粥样硬化病变比在后胫后动脉（34%）更频繁（p<0.0005）。这些动脉粥样硬化斑块大多是非动脉粥样硬化性的（后腘窝和后胫后斑块分别为 80%和 83%）。存在的动脉粥样硬化斑块较小（大多数<25%的斑块面积）。后腘窝动脉（39%）中观察到的动脉粥样硬化斑块钙化比后胫后动脉（17%）更常见（p<0.0005）。后胫后动脉（62%）中观察到的动脉中层钙化比后腘窝动脉（46%）更常见（p=0.008）。斑块钙化和动脉中层钙化与管腔狭窄无关。
在老年尸体的下肢中，从近端的腘动脉到更远端的后胫后动脉，动脉粥样硬化斑块和内膜钙化的存在减少，并且大多数动脉粥样硬化病变为纤维非动脉粥样硬化型。相比之下，从中段到远端，动脉中层钙化的存在和严重程度增加。
