. A, Attachment of a monocyte to an adhesion molecule on a damaged endothelial cell of an artery. The monocyte then migrates through the endothelium into the intimal layer of the arterial wall and is transformed into a macrophage. The macrophage then ingests and oxidizes lipoprotein molecules, becoming a macrophage foam cell. The foam cells release substances that cause inflammation and growth of the intimal layer. B, Additional accumulation of macrophages and growth of the intima cause the plaque to grow larger and accumulate lipids. Eventually, the plaque may occlude the vessel or rupture, causing the blood in the artery to coagulate and form a thrombus. (Modified from Libby P: Inflammation in ather