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An atheroma, or atheromatous plaque, is an abnormal accumulation of material in the inner layer of an arterial wall. [1] [2]The material consists of mostly macrophage cells, [3] [4] or debris, containing lipids, calcium and a variable amount of fibrous connective tissue.
Renal artery stenosis (RAS) is the narrowing of one or both of the renal arteries, most often caused by atherosclerosis or fibromuscular dysplasia. This narrowing of the renal artery can impede blood flow to the target kidney , resulting in renovascular hypertension – a secondary type of high blood pressure .
Generally an atheroma becomes vulnerable if it grows more rapidly and has a thin cover separating it from the bloodstream inside the arterial lumen. Tearing of the cover is called plaque rupture . However, a repeated atheroma rupture and healing is one of the mechanisms, perhaps the dominant one, that creates artery stenosis .
As long as the artery enlarges sufficiently to compensate for the extra thickness of the atheroma, then no narrowing ("stenosis") of the opening ("lumen") occurs. The artery expands with an egg-shaped cross-section, still with a circular opening. If the enlargement is beyond proportion to the atheroma thickness, then an aneurysm is created. [71]
These changes are most prominent in the kidney and can lead to ischemia and acute kidney failure. In the brain, a small cavity called a lacune is an ischemic cavity that can arise due to brain necrosis, due to arteriolosclerosis. [15] [16] Cause. It can be caused by chronic benign (essential) hypertension [17] malignant hypertension. [4] [18]
Kidney failure is known as the end-stage of kidney disease, where dialysis or a kidney transplant is the only treatment option. Chronic kidney disease is defined as prolonged kidney abnormalities (functional and/or structural in nature) that last for more than three months. [1]