Atherosclerosis is initiated by damage to the artery wall, leading to blood clot formation on the damaged site, which then gets covered and incorporated into the artery wall, potentially forming plaque.

“so essentially you know in a sort of nutshell you damage the amatory wall whatever causes that damage one of many many things once the damages occurred a blood clot will form must form on top of that and then you have a blood clot stuck to your artery wall”