Factors Influencing the Segmental Deposition of Atheromatous Material

Abstract

During the period of the last 7 or 8 years, in which operations on the aorta and its branches for atherosclerotic disease have been used extensively, it has been observed repeatedly that atheromatous material tends to be deposited in greatest concentration in the posterior wall of the abdominal aorta and common iliac arteries and at the orifices of branch vessels. The experimental work of Hass, Taylor, and their associates^4,8 has suggested the importance of physical factors in atherogenesis. It has occurred to us that anatomical factors which mechanically fix the abdominal aorta and the iliacs to the vertebral column and the bony pelvis may be instrumental in determining these sites of atheromatous predilection by restriction of the amplitude of pulsation of the dorsal arterial wall, impairment of capillary, or lymphatic drainage of lipid material from the area or by some other mechanism. Some degree of mechanical fixation of a