Arterial coarctation is the most aggressive disease in vascular surgery, with an in-hospital mortality rate of 27% and, if left untreated, death within 48 hours of diagnosis in 36%-72% of patients and within 1 week in 62%-91% of patients. Etiology of arterial coarctation: endothelial rupture or avulsion, which can occur in histologically normal aorta, but often with degenerative changes of the mesenteric elastic lamina. The main factors are loss of smooth muscle cells and increased intima-media elasticity. Advanced age and hypertension are the main etiologic factors. Blood flow is generally antegrade but may be reversed in terms of stripping and blood flow. Treatment of aortic coarctation: 23% death with type A coarctation surgery and 50% death with drugs. type B coarctation surgery versus drug therapy is controversial. Simple type B coarctation is primarily treated with drugs, while complex type B coarctation is primarily treated surgically.