Segmental Arterial Mediolysis: A Multiguised Vasospastic Arteriopathy with Collateral Mesangial Cell Hyperplasia and Cardiac Toxicity Generated by Norepinephrine and Hyperdense Adrenoceptors Alone or by Crosstalk with Other Pressor Agents

Figure 23

Segmental arterial mediolysis reparative phase showing evolution to FMD. The black arrow points to expanded tear space bordered by an intact external elastica filled with granulation tissue that extends upwardly at the red arrow to totally replace an irregular zone of lost medial muscle. The upper left internal elastica is missing, and the lumen is narrowed by a circumferential plaque of granulation tissue. The purple arrow points to a zone of intact media showing focal fibrosis. Movat stain ×25 (adapted with permission from Cardiovascular Pathology 18(6) copyright 2009 Elsevier Inc.).