Monckeberg's arteriosclerosis

As Moenckeberg sclerosis; engl. Moenckeberg 's sclerosis, medial sclerosis (of Moenckeberg ) or Mediakalzinose refers to a calcification of the middle wall layer ( tunica media ) of the extremities arteries. It occurs especially in diabetes mellitus and renal insufficiency. The inner lining of the vessel wall ( tunica intima ), in contrast to atherosclerosis is not involved. Both forms of vascular calcification can occur together or separately.

The medial sclerosis typically does not lead alone to a narrowing of the vessel lumen and thus does not lead to PAD, but can the vessel wall so strong harden that the artery is no longer compressed in accordance with the indirect measurement of blood pressure and so much to high blood pressures are measured ( pseudo hypertension).

Men are affected more often than women ( M: F = 3:1). Diabetes mellitus, renal insufficiency, and primary or secondary hyperparathyroidism contribute to the development of this vascular disease.

The name goes back to the first describer Johann Georg Moenckeberg ( pathologist ) ( 1877-1925 ).

Causes and development

Possible causes hypercalcemia and a degeneration of the smooth muscle of the larger arteries are accepted.

The mediasclerosis arises due to deposits of calcium salts ( apatite ) and lipids. In rare cases it can come ( with bone marrow) to the formation of osteoid or bone structures.

Clinical manifestations

The medial sclerosis leads to hard walls of the arteries. Therefore, it can lead to falsely high values ​​for indirect blood pressure measurement ( pseudo- hypertension). The measured values ​​can in some cases exceed 300 mmHg. Another independent clinical significance you will not get to. The medial sclerosis can be so obscure a " peripheral arterial disease " or lead to misdiagnosis.

Methods of investigation

The medial sclerosis is found as tubular calcification of arteries occasionally as an incidental finding during radiological examinations of the skeletal system. If corresponding underlying diseases in a patient previously unknown, such a finding may be an opportunity to search for it. Angiographically show the open vessels in the medial sclerosis without significant variations in the inner diameter. Typically, the pressure measured at the ankles by means of Doppler sonography blood pressure is at least 1 ½ times as high as at the wrist (ankle - brachial index > 1.5 ).

Pathology

On examination the affected arteries may have a fluting, which is reminiscent of the cartilage rings of the trachea (hence the medical history of traditional term " catheter mount arteries ").

Treatment

Treatment is not necessary due to lack of clinical relevance.