Obliterating endarteritis

Pathological anatomy. From the point of view of pathological morphology obliterating endarteritis is the notion of collective and heterogeneous when the generality of the main clinical manifestations of disease striking mainly limbs. This circumstance led to the introduction into the clinical practice of different indifferent signs (occlusive disease of the arteries, endarteriit and others) doesn't imply a pathological basis of disease. Practical frequency of atherosclerosis as the basis occlusion of arteries limbs, causing ischemia and gangrene, was even the reason for the generalized representation about it as about a special organ varieties of atherosclerosis. In fact, about 90% of all cases occlusive limbs has atherosclerotic origin, being a disease of the elderly. In the case of "spontaneous gangrene" young and middle aged atherosclerosis is often only associated or complicating the process, and the main is the defeat of arteries and veins of the extremities with a kind of pathology that (conditionally) can be described as endarteriit and phlebitis.
A classical picture of the defeat of arteries, described by Burger and subsequent authors, fit into the picture of allergic panarteritis with all stages of its development.
Usually at autopsy practice, the researcher has to do with the final, sclerotic stage of the process, when the affected vessel (or cut) is dense fibrous cord with obliteriruuschem clearance, and histological examination reveals scar germination of the wall and the obliteration of the lumen of the fibrous tissue with numerous newly formed vessels and channels. The last part is also in a state of partial or full fibrous obliteration. Along with these final stages of Takayasu can be found on separate sections of a picture of acute granulation inflammation with non-permanent presence in the infiltration of multi-core giant cells. Thrombus formation cannot be considered a permanent feature of Takayasu: it can accede to the main process in its various stages and strengthen occlusive events. The processes similar to those described, occur in vasa vasorum, which introduces additional complexity and the strengthening of occlusive lesions. Apparently, in order compensatory adaptation develops capillary angiomatosis intima. M. I. Pins detects such angiomatosis in the early stages of the process.
The basic process of Takayasu often secondary sandwiches atherosclerosis, which complicates morphological and pathogenetic analysis of the defeat and its identification. Atherosclerosis may have different mechanisms and conditions of development. It can develop as a result of anisotropic dystrophic obesity newly formed connective tissue in the area of Takayasu into a typical plot of atherosclerosis with calcification. It can develop proximal space inflammatory-sclerotic occlusion of the arteries due to regional hypertension caused by occlusion, based on the General laws of the development of atherosclerosis and the role of hypertensive factor (M Ya Styren).
Obliterating endarteritis, usually accompanied thrombophlebitis (see). In rare cases the latter may dominate in the pathology of suffering (tromboliticescoe form of gangrene).
In pathology obliterating endarteritis is defeated soft tissue, first of all muscles of the extremities, which is the result of complex trophic disorders (lack of blood supply, mobility impairments and nervous trophic and other). Severe shifts in case of insufficiency of collateral blood supply end gangrene limbs (see Gangrene).