Research Article
Volume 7 Issue 10 - 2020
Vascular Calcification and Crystal Deposition Diseases - A Comparative Study on 67 Amputated Legs with Atherosclerosis and/or Mönckeberg Sclerosis
Miklós Bély1* and Ágnes Apáthy2
1Department of Pathology, Hospital of the Order of the Brothers of Saint John of God in Budapest, Hungary
2Department of Rheumatology, St. Margaret Clinic Budapest, Hungary
*Corresponding Author: Miklós Bély, Department of Pathology, Hospital of the Order of the Brothers of Saint John of God in Budapest, Hungary.
Received: August 17, 2020; Published: September 23, 2021


Introduction: A wide spectrum of vascular calcification is known.

Aim of the Study: The aim of this study was to identify and characterize the major categories of arterial calcifications (AC): the atherosclerotic intimal calcification (Ath), and the artery calcification of Mönckeberg (MSc).

Patients and Methods: Characteristics of arterial calcification and crystal deposits were analyzed in 67 consecutive amputated lower limbs of 45 patients. One or both legs of patients were amputated, sometimes repeatedly at different levels.

The standard staining and reaction (H-E, Alizarin red, and von Kossa) were compared with unstained sections according to Bély and Apáthy (2013). This new, very sensitive method is suitable to identify cholesterol, hydroxyapatite (HA), calcium pyrophosphate dihydrate (CPPD), monosodium urate crystals, etc. in formalin fixed, paraffin embedded, unstained tissue sections viewed with polarized light.

Results: The mean age of the patients with atherosclerosis was significantly higher, than the mean age of patients with Mönckeberg sclerosis, but the difference was not as large as mentioned in the pertinent literature.

Between the two patient cohorts there was no significant difference in prevalence of arterial calcification and bone formation with or without true medullar spaces, but there were discrepancies in presence of crystals.

Discussion and Conclusion: Atherosclerosis and Mönckeberg sclerosis are different entities, characterized by cholesterol crystal deposition in Ath, and HA crystal deposition (with or without CPPD) in MSc. Overlaps between Ath and MSc are plausible.

Atherosclerosis is related to elevated low density lipoprotein concentration in blood, and Mönckeberg sclerosis may be consequence of a complex genetically determined metabolic disorder, a crystal induced angiopathy.

Bély and Apáthy’s “non-staining” technique is a useful method to distinguish atherosclerosis and Mönckeberg sclerosis.

Keywords: Atherosclerosis; Mönckeberg Sclerosis; Cholesterol; Hydroxyapatite; Calcium Pyrophosphate Dihydrate Crystals


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Citation: Miklós Bély and Ágnes Apáthy. “Vascular Calcification and Crystal Deposition Diseases - A Comparative Study on 67 Amputated Legs with Atherosclerosis and/or Mönckeberg Sclerosis”. EC Cardiology 8.10 (2021): 01-19.

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