Microembolic Complications of Atherosclerosis

Abstract

INTEREST in the microembolic complications of atherosclerosis (nodular arteriosclerosis) has evolved through three distinct phases. In the first, which lasted the better part of a century, pathologists recognized the occurrence of emboli of atheromatous gruel.^1-4 Despite, or perhaps because of the frequency with which these emboli occur, (Table 1) they were initially thought to have little clinical significance. The second phase opened with Flory's work in 1945,⁵ following which autopsy studies established the pathogenetic relationship of these emboli to disease. The organs frequently afflicted by these emboli were also identified (Table 2). The third phase, that of the diagnosis of microembolic complications of nodular arteriosclerosis during life and in their sublethal forms, is still in its infancy. One of the major developments in this phase has come from ophthalmologists and neurologists who have clearly established that there are at least two kinds of microemboli. The first, in