The mode of calcification in atherosclerotic lesions

In serveral arterial provinces, atherosclerosis and atherosclerotic calcifications are preceded by primary calcifications which develop in a seemingly unchanged arterial wall and often show regular gross patterns. In contrast, secondary calcifications which appear in the atherosclerotic lesions are irregularly distributed along the thickened atherosclerotic intima. At the predilection sites of atherosclerotic lesions, pronounced primary calcifications often precede the fatty streaking representing an independent pathological process. The deformation of the arterial wall resulting from calcific plaques may favor the activation of intimal mesenchyme and contribute to increased accumulation of lipid above and around calcific deposits. The exact nature of structural and biochemical changes which precede and result in primary and secondary arterial calcification still remains obscure.