[Pathological deformities of carotid arteries: aetiology, pathogenesis, clinical and pathomorphological alterations]

The study was aimed at examining cases of pathological deformities of carotid arteries (PD CA) as one of important causes of extracranial impairments of cerebral circulation. We examined a total of 254 biopsy samples obtained after surgical interventions. PD CA was combined with other diseases: almost in half of cases (47.2%) with atherosclerosis, in nearly one third of cases (27.9%) with atherosclerosis and fibromuscular dysplasia, with fibromuscular dysplasia in 14.5% of cases. PDs with no concomitant pathology were rare events encountered in only 26 (10.2%) patients. There were 158 (62.2%) women and 96 (37.8%) men. The patients' age varied from 18 to 79 years. It was proved that young adults develop PD without pre-existing vascular diseases, with its characteristic type being coiling. PDs in patients over 40 years old develop in consequence of atherosclerosis, fibromuscular dysplasia, exposure to toxic substances, with a characteristic type of PD being coiling. The pathomorphological examination of CA demonstrated intimal hyperplasia with smooth muscle cell proliferation, irreversible alterations of the medial elastic fibres with proliferation of fibrous connective tissue and dystrophy of collagen fibres and smooth muscle cells, as well as perivascular sclerosis without cellular infiltration in the adventitia. More accurate determination of the aetiology and pathogenesis of PD CA requires further pathomorphological studies aimed at specifying morphogenesis characteristic of each type of PD.