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Lesions of the aorta are rather common and include the aneurysmal, arteriosclerotic, fistula, and dissection types. Less common are the thrombotic, especially the acute occlusive episodes, lesions of the aorta. Sudden severe painful symptoms usually develop with the formation of an acute intraluminal aortic thrombosis. When the lesion is only partial and productive of lesser symptoms, treatment may be conservative utilizing anticoagulant therapy. When the thrombosis is sudden, totally obstructing, and productive of severe symptoms or morbid loss of function, emergent diagnosis and therapy will follow. Such lesions may result from embolic, acute dissection, malignancy, blood flow abnormalities, as well as iatrogenic causes including invasive techniques or stirrup positioning of extremities for surgery. Prognosis depends on the severity of the obstructive lesion, the underlying cause, the patient condition on presentation and the response to therapy.

Aortic disease, known for centuries, originally resulted from infectious processes or trauma. Treatment programs were primarily symptomatic and included diet and rest. The timeline for a vascular concept and disease development along with successful treatment programs has been slow and punctuated by multiple failures. With the scientific and community developments of the 1800s, such as electricity, the germ theory, the improved understanding of the cardiovascular system and circulation, along with anesthetics, the past 150 years has seen a progressive change in the diagnosis and successful treatment of aortic diseases whether infectious, obstructive, hemorrhagic, or aneurysmal in nature. Evolution has seen the virtual disappearance of syphilitic aneurysms and the appearance of atherosclerotic degenerative aneurysms, obstructive aortic disease, aortic dissection, inflammatory and genetic lesions. Our timeline progresses through nearly 2000 (especially the last 200) years of vascular and aortic disease diagnosis and treatment.