The ratio of Type I to III collagen was shown to be reduced in skin fibroblasts, fascia transversalis, and the hernial sac in patients with inguinal and incisional hernia.12, 14Collagens, which are major structural components of the ECM in the aorta and provide support and strength to the aorta, have also been shown to play a role in AAA development and rupture.3 This evidence concerns the gene SGCG and triple-A syndrome.