“…8,9 Nickel and titanium alloys promote an inflammatory response in soft tissue by activating human monocytes 10 and can change cellular vulnerability to extreme temperatures, potentially signifying oncogenic alterations in antiapoptotic pathways. 11 Thus, placement of endovascular stents in aneurysms that already demonstrate inflammation may theoretically potentiate an existing predisposition to vascular neoplasia, especially in younger patients with stronger innate and adaptive immunity. 12 One plausible explanation could be pre-existing tumor in the setting of intense inflammation in the original aneurysm sac, analogous to a previous description of carotid artery leiomyosarcoma, 13 although this has not been described in inflammatory aortic aneurysms.…”