These are commonly found in elder patients with a long-standing history of high blood pressure and smoking. The ulcerations are commonly found on the descending thoracic aorta and aortic arch.
The damage to the layers of the aortic wall is believed to be from atherosclerosis and calcification. A small defect in the inner layer of the aorta allows blood to slowly create a crater into deeper layers of the aorta. The aortic wall in this area can become weakened and an aneurysm may form in this area.
Atherosclerotic ulceration can lead to aortic rupture. Patients who have pain should be considered for surgical or endovascular therapy. Blood pressure control is extremely important.