LOCALIZATION OF EARLY ATHEROSCLEROTIC LESIONS IN AN ARTERIAL BIFURCATION IN HUMANS

Abstract

The detailed localization of early atherosclerotic lesions in arterial bifurcations was studied in 33 brachiocephalic arteries obtained from autopsies of young persons. Drawings of the sudanophilic lesions in the vessel wall were fed to a computer, scaled to a standardized size and shape, and added together. The results are presented as contour lines connecting points with equal frequency of early lesions. The distribution of the early lesions reveals a distinct pattern: the early lesions start to develop on the outer walls of the bifurcation, while the inner walls downstream from the flow divider and the lateral walls are kept free. These results clearly conflict with Fry''s shear stress hypothesis, while they seem to support Caro''s hypothesis of inhibition of local diffusional transport. The results are at variance with results obtained in most animal models, suggesting that the process which occurs in the vessel wall in these animals may differ from human atherosclerosis.