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1 . 2026

Histological changes of the aortic wall in the area of the proximal neck of an aneurysm upon rupture

Abstract

Objective. To study the state of tissues of the aortic wall in the area of the proximal neck of an aneurysm in patients with lethal outcomes due to aneurysmal rupture.

Materials and methods. A fragment of the aortic wall for histological examination was procured from the area of the proximal neck of aneurysms in 16 patients who died from ruptured aneurysms of the abdominal and thoracic aorta. The fragment of the aortic wall to study was taken at a distance from 1 to 4 cm above the upper pole of the aneurysm. The specimens after being treated with phosphotungstic acid were stained with hematoxylin and eosin, aniline blue.

Results. Damage to all layers of the aortic wall was revealed at a distance of 1 cm from the upper pole of the aneurysm. The most pronounced changes were observed in the medial layer. At a distance of 2 cm from the upper pole of the aneurysm, the aortic wall was found to contain atherosclerotic plaques circumscribed by a thick, dense layer of collagen fibers with diffuse hyalinosis. At a distance of 3 cm from the upper pole of the aneurysm, there was a decrease in the severity of the lesion of the aortic wall. At a distance of 4 cm from the upper pole of the aneurysm, in the media predominated foam cells, visualizing pronounced medial atrophy, with replacement of elastic fibers by coarse collagen fibers.

Conclusion. In patients with ruptured aortic aneurysms, the structural integrity of the aortic wall begins at a distance of 4 cm above the upper pole of the aneurysm, which should be taken into consideration when performing surgical treatment.

Keywords: aortic rupture; aneurysm; atherosclerosis; histological changes; calcification

Funding. The study had no financial support.

Conflict of interest. The authors declare no conflicts of interest.

Authors’ contribution. Study conception and design – Khafizov T.N., Shumkin A.M., Shchekin S.V., Imaev T.E.; data collection and handling, preparation of illustrations – Shumkin A.M., Shchekin S.V., Manylova V.R.; verification of critically important content – Shumkin A.M., Shchekin S.V., Manylova V.R., Imaev T.E.; draft manuscript preparation – Kataev V.V., Zagidullin B.I., Khafizov R.R.; review, manuscript revision – Khafizov T.N., Shumkin A.M., Shchekin S.V., Imaev T.E.

For citation: Khafizov T.N., Kataev V.V., Shumkin A.M., Shchekin S.V., Zagidullin B.I., Manylova V.R., Khafizov R.R., Imaev T.E. Histological changes of the aortic wall in the area of the proximal neck of an aneurysm upon rupture. Angiology and Vascular Surgery. Journal named after Academician A.V. Pokrovsky. 2026; 32 (1): 10–5. DOI: https://doi.org/10.33029/1027-6661-2026-32-1-10-15

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CHIEF EDITOR
CHIEF EDITOR
Yuri V. Belov
Academician of the Russian Academy of Sciences Doctor of Medical Sciences, Professor, President of the Russian Society of Angiologists and Vascular Surgeons

 

In accordance with the decision of the Presidium of the Russian Society of Angiologists and Vascular Surgeons, the journal "Angiology and Vascular Surgery" will be named after Academician A.V. Pokrovsky starting from No. 2/2022.

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