1.Pathogenesis After the wall of the thoracic aorta is damaged by certain pathological factors, the high-speed, high-pressure aortic blood flow tears its inner membrane, separating the inner and outer membranes of the aorta, forming a sandwich, and causing the outer membrane of the thoracic aorta near the rupture to expand and form an aneurysm. 2. Pathogenesis The main causes are hypertension and atherosclerosis. Qiao Tong, Department of Vascular Surgery, Nanjing Gulou Hospital 3.High-risk group Middle-aged men with hypertension. 4.Common manifestations Tear-like pain in the chest and back and high blood pressure that cannot be easily controlled. 5.Risk hazard More than 80% of thoracic aortic coarctation aneurysms have a history of hypertension, and patients with poorly controlled hypertension, unstable hypertension and young hypertension are more prone to this disease. This has led to a trend toward younger patients with thoracic aortic coarctation aneurysms. The aneurysm-like expansion of the outer membrane of the thoracic aortic wall may rupture at any time, leading to massive bleeding and rapid death of the patient. 6.Treatment principle We must pay attention to the control of blood pressure, and if sudden onset of severe chest and back pain in daily life, we should go to the hospital for a comprehensive examination in time, and once found, we should promptly diagnose and treat. 7.Treatment countermeasures (1) Transthoracic coarctation aortic aneurysm resection + artificial vessel replacement surgery This is the classic method to treat coarctation aneurysm of thoracic aorta. The procedure varies slightly according to the site involved in the coarctation aortic aneurysm. The general steps include: extracorporeal circulation, cryo-brain protection, chest opening, dissection of the thoracic aorta, blocking the blood flow of the thoracic aorta, resection of the diseased segment of the thoracic aorta, and anastomosis of the two ends of the artificial vessel to the normal aorta at the two ends of the lesion. However, the surgery is very traumatic, and the complication and mortality rates are high. (2) Intracavitary isolation of aneurysms Minimally invasive treatment method. The emergence of endoluminal isolation is considered another revolution in the history of surgical treatment of thoracic aortic coarctation aneurysms. By using an artificial vessel to isolate the high-speed, high-pressure thoracic aortic blood flow from the diseased vessel wall, the blood flow no longer enters the interstitial layer through the endothelial opening, but enters the distal aorta and no longer impacts the dilated outer membrane of the thoracic aorta, and its rupture can be prevented for the purpose of cure. Compared with traditional open-chest mega-invasive surgery, the most prominent feature of endoluminal isolation is that it is minimally invasive, and the surgery can be completed with a small 3 cm-long incision at the root of the thigh. Patients recover quickly after surgery, with low complication and mortality rates, and can give many patients who cannot tolerate traditional surgery due to advanced age and multiple coexisting diseases a good chance of treatment.