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. 2021 Jan 7;10(2):e018633. doi: 10.1161/JAHA.120.018633

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© 2021 The Authors. Published on behalf of the American Heart Association, Inc., by Wiley.

This is an open access article under the terms of the http://creativecommons.org/licenses/by-nc-nd/4.0/ License, which permits use and distribution in any medium, provided the original work is properly cited, the use is non‐commercial and no modifications or adaptations are made.

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A man had a middle artery aneurysm (triangle arrow).

(A1) with a uniform atherosclerosis appearance (star) on intraoperative imaging (A2), which had significant enhancement (arrow) on postcontrast vessel wall magnetic resonance imaging (A4). A hematoxylin and eosin stain (B) showed the thickened aneurysm wall contained hemosiderosis (star) and calcification (triangle). A vascular smooth muscle cells (SMC) stain (C) indicated hyperplasia and derangement of SMCs within the aneurysm wall (double arrow). Clustered inflammatory cells, including CD68+ macrophages (D), myeloperoxidase+ (MPO+) leukocytes (E), and T and B lymphocytes, were noticed within the aneurysm wall, and CD34 stain (F) indicated plenty of neovascularization within the aneurysm wall.