Interaortic wall hematoma refers to intra-aortic wall hemorrhage or limited hematoma formation within the aortic wall as a specific type of aortic coarctation. The most common cause is cystic necrosis of the middle aorta and rupture of the trophoblastic vessels or “aortic wall infarction”, with blood spilling into the outer layer of the mesentery near the epicardium, and another possible cause is plaque rupture. Hypertension, blunt chest trauma and giant cell arteritis are also possible causes. Irrespective of the anatomical location of the onset, chronic hypertension and Marfan syndrome are the two main associated factors, other factors such as diabetes, pregnancy, a history of heavy continuous smoking or abdominal aortic disease are also common in patients with IMH, making its pathogenesis multifactorial. Clinical presentation: As with typical entrapment, almost all patients present with sudden onset acute chest or back pain, some with abdominal pain, and some with no symptoms. The pain may present as sharp cutting, tearing, or dull pain, and the patient’s description of the pain may vary from person to person, but the pain in patients with aortic coarctation is characterized by its metastatic or extended chest pain. A pain-free phase may follow the initial pain, lasting from a few hours to a few days, and then some patients experience pain again. Recurrence of pain after this pain-free interval is an ominous sign and usually signals imminent rupture. The main limitation of TEE is the experience of the examiner, as the examination is limited to the thoracic aorta and proximal abdominal aorta, and is difficult below the abdominal trunk. It is difficult to see below the abdominal trunk. Esophageal varices cannot be performed. Intravascular ultrasound: IMH shows thickening of the aortic wall, including anechoic areas (images that cause delamination of the aortic wall) or structures with inhomogeneous echogenicity within the aortic wall. Aortography: Aortography is of little diagnostic significance for IMH because there is no intimal breach, but a careful and thorough examination helps us to rule out aortic ulceration or intermural hematoma secondary to a microscopic limited entrapment. Prognosis: The natural history of intermural aortic hematoma is similar to that of typical entrapment, with complication rates and mortality related to the site of involvement. In addition to endothelial rupture that transforms into a classic entrapment, the aortic wall can be penetrated deeper leading to rupture or pseudoaneurysm formation. 25 patients with aortic intermural hematoma reported by Nienaber et al. progressed to classic entrapment rupture and/or acute pericardial tamponade in 8 cases (32%) within 24 to 72 hours. Endoluminal stenting of the aorta is an important method widely used in recent years for the treatment of aortic coarctation, especially type B coarctation, and currently we have a perioperative mortality rate of approximately 2% for endoluminal treatment and no perioperative mortality for endoluminal treatment of intermural hematoma. Therefore, we advocate that endoluminal stenting should be actively performed for B-type aortic intermural hematoma with potential rupture risk.