Pathophysiology and pathogenesis of aortic aneurysms. Current concepts.

From an engineering point of view, the development of an arterial aneurysm is a classic case of material failure that may involve two factors: excessive applied load and inadequate material strength. The author describes a hypothesis that explains how atherosclerosis could increase the pressure load on the vessel and at the same time decrease the capacity of the wall to bear that load. It will be of interest to learn precisely what the genetic trait is that causes the atherosclerotic aorta to fail structurally in some patients while allowing the vessel to remain intact and develop occlusive lesions in others.