Commentary: Current understanding of the role of atherosclerosis in aneurysmal disease is incomplete

The group at Yale has extensive experience with treatment of aortic disease and has widely published on the topic. In the current brief report,1 they address a hypothesis that differs distinctly from the common belief that aortic aneurysms are generally associated with atherosclerotic disease. While the aorta is considered a single entity, it has been observed to behave differently in various anatomic sections. Having observed that their patient population operated for ascending thoracic aortic aneurysms (ATAA) less frequently had grossly apparent atherosclerotic disease in the aneurysmal segments compared with those operated for descending thoracic aortic aneurysms, the authors undertook to examine the relationship between low-density lipoproteins and the presence or absence of ATAA.