A 72-year-old man with a 55-pack-year smoking history and long-standing hyperlipidemia presents to clinic for evaluation of an incidental finding on CT angiography obtained after a fall. Imaging shows a fusiform aneurysmal dilation of the descending thoracic aorta. He denies chest pain. On review of systems, he reports progressive shortness of breath and a chronic cough over the last few months. Vital signs are normal. Which of the following is the most likely underlying pathogenesis of this patient’s aortic lesion?
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