In the Injury Theory, it's damage to the arterial endothelium, followed by platelet activation, then smooth muscle cell migration to injury, then macrophages, with resulting "foam cells." Engorged foam cells burst, starting the injury cycle all over again
In much of the world (but not in the U.S.,) drug-coated stents are avoided by cardiologists because of their high cost. To compensate for the inability to use these stents, many cardiologists outside of the U.S. have taken to administering sirolimus (also