Pathologic examination of aortic coarctation segments revealed cystic medial necrosis in 100% of specimens, with 67% graded as severe, providing a basis for post-angioplasty aneurysms.
Observational (n=33)
Is cystic medial necrosis a consistent histologic feature in patients with coarctation of the aorta?
Cystic medial necrosis is a consistent histologic feature in aortic coarctation, providing a pathologic basis for aneurysm formation observed after balloon angioplasty.
Percutaneous transluminal angioplasty has been shown to be both feasible and efficacious for the treatment of aortic coarctation. Recent reports, however, have indicated that the development of aortic aneurysms at or near the coarctation segment may complicate attempts to treat this lesion by catheter-based intervention. Accordingly, we examined the light microscopic features of coarctation segments excised at surgery (n = 31) or obtained at autopsy (n = 2) in 33 patients with coarctation of the aorta. Cystic medial necrosis, defined as depletion and disarray of elastic tissue, was observed in each of the 33 specimens. In the majority of coarctation specimens (22 of 33 or 67%) the extent of cystic medial necrosis, graded semiquantitatively on a scale of 0 (normal aorta) to 3+, was severe (3+). The finding that cystic medial necrosis represents a consistent histologic feature of coarctation of the aorta provides a pathologic basis for the formation of aneurysms observed after balloon angioplasty of coarctation sites.
Isner et al. (Wed,) conducted a observational in Coarctation of the aorta (n=33). Coarctation of the aorta was evaluated on Presence of cystic medial necrosis. Pathologic examination of aortic coarctation segments revealed cystic medial necrosis in 100% of specimens, with 67% graded as severe, providing a basis for post-angioplasty aneurysms.