• Aortic resection is most frequently performed for aneurysm repair or aortic dissection.  Underlying causes often include atherosclerosis, medial necrosis. 
• The elements to look for are plaques, calcification, mural hemorrhage (dissection) and fibrosis.
• If mural hemorrhage is present, describe the size and shape (e.g., wedge-shaped), and whether dissection is present or not.
• Specimen often composed of both the aortic wall and large fibrin clots.  To identify the vascular wall component, grab a piece of tissue with your fingers and try to pull it apart.  Fibrin clots are easily broken whereas the vascular tissue is elastic and very hard to break. This can markedly reduce the number of unnecessary blocks (of the fibrin clots).

• Full-thickness sections of wedge-shaped mural (hemorrhagic) dissection area, esp. the dissection front (i.e. the tip of the dissecting wedge).
• Full-thickness of aortic wall with atrophy, fibrosis or hemorrhage.

Internal use only

Received without fixative / in formalin, labeled “_____” and “aorta aneurysm”, is  a ___ x ___ cm portion of aortic wall and multiple irregular shaped yellow-tan fibrin clots aggregating __ x __ x __ cm. The possible inner surface of the aortic wall is ___ (smooth / variegate / atheromatous) with ____ (yellow streaks / calcifications).  Serial sections reveal -- cm-thickness wall with __ cm long ___ (wedge shaped mural hemorrhage / dissection / mural calcification). The attached soft tissue is __ (hemorrhagic / unremarkable).  Representative sections are submitted as follows:

#__ & #__ = aortic wall with mural hemorrhage / dissection, two pieces in each cassette.

#__ = fibrin clots

__ blocks, __ H&E slides