Incriminating Evidence for the Role of the Microvasculature in Atherosclerosis



Different vascular beds show a different susceptibility to atherosclerosis and, even within diseased vessels themselves, plaques display a distinct localization. Vasa vasorum and blood vessel wall lymphatics are distinctly distributed in the arterial system and we propose that their differential distribution plays an important role in the site specificity of disease manifestation. We present the current evidence that obstruction, hypoperfusion, or leakage of vasa vasorum as well as lymphatic dysfunction leads to plaque development. There is also sufficient evidence to postulate a similar pathomechanism in arterial aneurysm and dissection. In atherosclerosis research, the primary focus is always on the endothelium of the parent vessel when, as we will suggest in the following chapter, it is the endothelium of the vasa vasorum that is more susceptible to dysfunction during all stages of disease.


Atherosclerosis Arterial aneurysm Dissection Risk factors Dietary cholesterol Homocysteine Air pollution Microbiota clonal hematopoiesis of indeterminate potential Inflammation 


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Authors and Affiliations

  1. 1.Hannover Medical SchoolHannoverGermany

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