atheromatöse

Atheromatöse is an adjective used in pathology to describe lesions of the arterial wall associated with atheroma formation. It denotes changes typical of atherosclerosis, most commonly affecting coronary, carotid and peripheral arteries.

Histologically, atheromatöse plaques consist of a lipid-rich core covered by a fibrous cap. Foam cells, macrophages and inflammatory cells accumulate in the intima, and the plaque may become calcified over time. Plaque stability varies: a thin fibrous cap over a large necrotic core increases the risk of rupture, which can trigger thrombosis.

Clinically, atheromatöse plaques can narrow the vessel lumen (stenosis) and reduce blood flow, leading to ischemic symptoms such as angina, transient ischemic attack or stroke, and peripheral arterial disease. Rupture or erosion of an unstable plaque often causes acute cardiovascular events.

Risk factors for atheromatöse lesions mirror those of atherosclerosis and include non-modifiable factors such as age and family history, and modifiable factors such as elevated LDL cholesterol, hypertension, diabetes, smoking, obesity and sedentary lifestyle. Detection relies on imaging techniques like carotid ultrasound, CT angiography and MR angiography; histology confirms the diagnosis in tissue samples.

Management focuses on risk reduction and symptom control. Lifestyle modifications and lipid-lowering therapy (notably statins) are central, along with blood pressure and glucose management and antiplatelet therapy as indicated. In significant disease, interventional approaches such as angioplasty with or without stenting or surgical bypass may be required.