Circumferential heterogeneity in the abdominal aortic aneurysm wall composition suggests lateral sides to be more rupture prone Rob Hurks, MD, Gerard.

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Presentation transcript:

Circumferential heterogeneity in the abdominal aortic aneurysm wall composition suggests lateral sides to be more rupture prone Rob Hurks, MD, Gerard Pasterkamp, MD, PhD, Aryan Vink, MD, PhD, Imo E. Hoefer, MD, PhD, Michiel L. Bots, MD, PhD, Henricus D.W.M. van de Pavoordt, MD, PhD, Jean-Paul P.M. de Vries, MD, PhD, Frans L. Moll, MD, PhD Journal of Vascular Surgery Volume 55, Issue 1, Pages 203-209 (January 2012) DOI: 10.1016/j.jvs.2011.06.113 Copyright © 2012 Society for Vascular Surgery Terms and Conditions

Fig 1 Schematic overview shows abdominal aortic aneurysm (AAA) tissue collection and processing. A circular biopsy specimen at the site of maximum diameter was collected and cut into segments as illustrated. Dorsal (D), ventral (V), left (L), and right (R) lateral sides were identified. For each side, a segment of full-thickness AAA wall was processed (gray area) for histology and for protein extraction. Other segments were stored for future use. Journal of Vascular Surgery 2012 55, 203-209DOI: (10.1016/j.jvs.2011.06.113) Copyright © 2012 Society for Vascular Surgery Terms and Conditions

Fig 2 Overview of the circumference of a normal aorta in hematoxylin and eosin (H&E) staining. Representative photomicrograph shows the homogeneous distribution of structural components and lack of inflammation in the normal infrarenal aorta. The scale bar represents 1 mm. Journal of Vascular Surgery 2012 55, 203-209DOI: (10.1016/j.jvs.2011.06.113) Copyright © 2012 Society for Vascular Surgery Terms and Conditions

Fig 3 Histologic overview shows the different sites of the abdominal aortic aneurysm in the same patient, stained for CD20-positive B lymphocytes. Representative photomicrographs show different sites within one abdominal aortic aneurysm: dorsal (D), ventral (V), left (L), and right (R) lateral segments surround the lumen. The intima is for all four regions located at the luminal side, and the adventitia forms the outer borders of the picture. Note the higher quantity of inflammation in both lateral sides. The scale bar represents 1 mm. Journal of Vascular Surgery 2012 55, 203-209DOI: (10.1016/j.jvs.2011.06.113) Copyright © 2012 Society for Vascular Surgery Terms and Conditions

Fig 4 Distribution of the proportion of the adventitia covered with inflammation in relation to different abdominal aortic aneurysm (AAA) sites. This graph shows the distribution of the percentage of adventitia that is covered with inflammation. Note that there is a difference among groups (Friedman test P < .001), with lateral inflammation being higher than both ventral (Wilcoxon sign test P = .001) and dorsal (Wilcoxon sign test P < .001) segments. Journal of Vascular Surgery 2012 55, 203-209DOI: (10.1016/j.jvs.2011.06.113) Copyright © 2012 Society for Vascular Surgery Terms and Conditions