A clogged aneurysm (aortic dissection, aneurysmal hematoma) is usually a fatal condition in which a tear occurs in the inner layer of the aorta while the outer layer remains intact, and blood flow separates the middle layer of the vessel through the tear, creating a new channel within the aortic wall. What is a clogged aneurysm Degeneration of the arterial wall is the cause of most clogged aneurysms. The most common cause of degeneration is hypertension, which is present in more than 2/3 of patients with a coarctation aneurysm. Other causes are: hereditary connective tissue diseases, especially Marfon syndrome and Ehlers-Danlos syndrome; birth defects of the heart and blood vessels such as aortic constriction, patent ductus arteriosus and aortic valve defects, atherosclerosis, and injury. Rarely, it occurs when a physician performs intra-arterial cannulation (performs an aortogram or coronary angiogram) or performs surgery on the heart and blood vessels. What symptoms are present Almost every patient with a coarctation aneurysm will experience pain, typically a sudden onset of severe pain. Patients often describe the pain as tearing-like pain in the chest. The pain also often occurs in the interscapular region of the back. As the arterial dissection extends along the aorta, the pain also extends along the dissection pathway. Progression of the dissection may lead to occlusion of one or more branch arteries attached to the artery. The symptoms that appear depend on the site of arterial occlusion: e.g. stroke, myocardial infarction, sudden abdominal pain, nerve damage (causing a tingling sensation and immobility of one limb), etc. What treatment is available Patients with a clogged aneurysm should be admitted immediately to the intensive care unit (ICU), where the patient’s vital signs (pulse, blood pressure and respiratory rate) are closely monitored. Patients can die within a few hours of onset. Therefore, physicians should use medications as quickly as possible to lower the heart rate and blood pressure to the lowest level that will maintain the blood supply to vital organs (heart, brain and kidneys). After the use of medications, a decision should be made as soon as possible whether surgical treatment or continued treatment with medications is needed. Unless the complications of a coarctation aneurysm make surgery much more dangerous, patients with coarctation aneurysms whose lesions involve the first few centimeters of the proximal end of the aorta should be treated surgically. In contrast, patients with a coarctation aneurysm located at the distal end can often continue to be treated with medications, except in patients with arterial blood leak due to coarctation aneurysm or Marfon’s syndrome. In both cases, surgical treatment is necessary. During surgery, the surgeon removes as much of the arterial stripping area as possible to prevent blood from entering the false passage (arterial entrapment) and reconstructs the aorta with an artificial vessel. If aortic regurgitation is present, valve repair or replacement is performed. What I can do The disease has a sudden onset, is severe and rapidly progressive, and occurs in men aged 60-70 years with a history of hypertension and in women under 40 years of age in late pregnancy, so hypertensive patients in this group should have their blood pressure actively and effectively controlled. Once severe chest and back or lumbar abdominal pain occurs, medical attention should be sought promptly without delay. Except for a few cases, conservative medical treatment for this disease is ineffective, and if surgery is determined to be necessary after examination, surgery should be performed as soon as possible. What Can Happen Approximately 75% of patients with untreated entrapment aneurysms die within two weeks of onset. Conversely, 60% of patients who survive the first two weeks of disease with treatment survive for more than 5 years, with 40% of them surviving for at least 10 years. Of the patients who die within the first two weeks, 1/3 die from complications and the other 2/3 die from other diseases. Currently, in large specialized medical centers, the operative mortality rate for proximal coarctation aneurysms is approximately 15%, which is higher than the operative mortality rate for distal coarctation aneurysms. All patients with a coarctation aneurysm (including those who have undergone surgery) should be given long-term medication to keep blood pressure low and reduce pressure on the aorta.