The pathogenesis of atherosclerosis.

Duguid (1946, 1952) extended Rokitansky's earlier observations by suggesting that encrustation of fine platelet deposits and films of fibrin on the endothelium provokes an inflammatory response that results in organization by scarring. This view has been modified by supposing that local fibrinolytic activity in the arterial wall may control the equilibrium between encrustation and solution of fibrin (Astrup, 1959). Although Duguid's mechanism does not in itself explain how lipid enters the arterial wall, a subsequent suggestion is that vasoactive compounds from encrusted platelets increase endothelial permeability and thus permit lipid to enter (Mustard, 1967, 1970; Constantinides and Robinson, 1969).