An update on the cause of abdominal aortic aneurysms

Historically the most common cause of abdominal aortic aneurysms has been attributed to atherosclerotic degeneration of the vessel wall. However, over the last decade this widely accepted theory has been challenged by a substantial body of research that proposes that atherosclerosis is more likely to be an associated finding rather than an instigating factor. Arguments against an atherosclerotic theory are supported by differences in the characteristics of atherosclerotic occlusive disease and aneurysmal disease. Emerging theories propose that development of abdominal aortic aneurysms involves genetic factors and fundamental structural changes in the aorta. The purpose of this article is to review these emerging theories and discuss their implications on patient treatment.