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Aortic aneurysms are most commonly caused by atheroma, which refers to the buildup of cholesterol plaques in the arterial wall. This process is often a result of atherosclerosis, a condition characterized by the thickening and hardening of arterial walls due to fatty deposits. Atheroma can weaken the structural integrity of the aorta, making it susceptible to dilation and subsequent aneurysm formation.

As the atherosclerotic disease progresses, the affected area of the aorta becomes less elastic and more prone to rupture or bulging, leading to an aneurysm. This condition is particularly prevalent in individuals with risk factors such as hypertension, smoking, hyperlipidemia, and diabetes, which contribute to vascular damage. Understanding the primary role of atheroma in the development of aortic aneurysms underscores the importance of managing cardiovascular risk factors for prevention.

The other causes, while relevant in certain contexts, do not account for the majority of aortic aneurysms. For instance, infections can lead to aneurysms, but they are rare and usually associated with specific pathogens, such as syphilis or mycotic infections. Similarly, trauma can cause vessel injuries that result in aneurysms, but this mechanism is not as common