What is the pathogenesis of atherosclerosis?

Multifactorial: Disease in the media( middle layer) of the artery with accumulation of fat, cholesterol into the wall causing inflammation which become chronic with special white blood cells called macrophages. Sometimes become calcified and sometimes can ulcerate or rupture into arterial lumen inducing emboli or clot/ thrombosis.

White Blood Cells: White blood cells, mostly macrophages, invade into the walls of the blood vessel to remove low density lipoprotein (fat carrying protein) particles. Macrophages die if overwhelmed with ingested fat molecules & cannot export ingested fat into high density lipoprotein particles. Elevated glucose & blood pressure, even mild, genetics, inactivity, smoking, sugars, not resolving emotional stress, etc.