Elastin and collagen fibres alterations for abdominal aortic aneurysms population with constant maximum diameter size

Development of abdominal aortic aneurysm (AAA) is a dynamic process proceeding as a result of the multi-factor pathological remodelling of elastin and collagen fibres, results an aneurysm expansion. In clinical practice, development of AAA is identified with aneurysm growth. Hence, the aim of this paper is to propose a taxonomy of load-bearing structural components alterations for AAA with relatively constant maximum diameter (average diameter 6.9±0.8 cm). Structural investigations of normal (n=47) and aneurismal (n=46) vessels were carried out on the basis of histological and ultrastructural examinations. The histological preparations were subjected to histometric evaluation; the number of collagen and elastin fibres and additionally the thickness of the particular vascular wall layers. A qualitative analysis of the abdominal aortic wall, mainly estimation of fibres arrangement, based on histological and ultrastructural (SEM) examinations were additionally performed. Using a cluster analysis, three stages of load-bearing fibres alterations for AAA population were distinguished. The clusters were systematized according to NAA results. For AAA population with relatively constant maximum diameter in the first stage of load-bearing fibres remodeling was observed a substantial loss of elastin fibres. The second stage is characterized by an increase in the number of collagen fibres. In the final stage the number of collagen is dramatically reduced. Presented results provide evidence to risk of AAA rupture is not connected with AAA size but a remodelling of extra-cellular matrix proteins. The remodelling is accompanied by changes in the AAA wall thickness, which should be taken into consideration when evaluating the degree of advancement of this disease.