ELN and triple-A syndrome: Thus, the destructive pathological remodeling of aorta in AAA involves four interrelated factors, namely (a) chronic inflammation of the outer wall of aorta along with neovascularization and upregulation of proinflammatory cytokines, (b) hyper-production and dysregulation of matrix degrading enzymes, (c) progressive destruction of elastin to generate bioactive EDPs, and of collagen and (d) apoptosis of medial SMCs incited by the EDPs (54, 55).