In a brief historical review the contributions of Rokitansky, Virchow,
and Langhans concerning the pathogenesis of arteriosclerosis and the
histogenetic puzzle of intimal cells classification are described. The
n, some unresolved problems are discussed, especially the localization
and distribution of arteriosclerotic plaques, the shape of endothelia
l cells and the orientation of their nuclei in correlation to local he
modynamic stress under normal and pathologic conditions. Some differen
ces between experimental arteriosclerosis and arteriosclerosis in huma
ns are illustrated by examples. The key role of the endothelium in the
development of arteriosclerosis is well founded. According to recent
investigations some cells on the surface of human arteriosclerotic pla
ques appear to be of non-endothelial origin. Arteriosclerosis seems to
be a systemic disorder with multiorgan involvement. Individual cases,
however, show significant differences in the distribution and extent
of lesions. Today, arteriosclerotic research is focused on arteries be
ing most important in clinical investigations. Nevertheless, there are
also other arteries with severe arteriosclerotic lesions for example,
the degree of arteriosclerosis in periprostatic arteries is more pron
ounced than in coronary artery branches of the same size. Finally, the
importance of primary prevention of arteriosclerosis is emphasized.