The surgical pathology of large vessel disease

The common disorders that affect large vessels are atherosclerosis, idiopathic proximal aortic dilatation (annulo-aortic ectasia), and cranial arteritis. Although an increasing number of patients undergo vascular surgery, especially carotid endarterectomy, we receive only about 250 vascular biopsies annually. Most are diagnosed easily. The most difficult diagnostic areas are the assessment of inflammatory infiltrates in aortic biopsies, the accurate identification of healed or healing cranial arteritis and the differentiation of Buerger's disease from atherosclerosis.