Shaggy aorta: ideal substrate for disaster

Shaggy aorta (SA) is characterized for an extensive and severe atheromatous disease. This degenerative, extensive and dangerous pathology is the result of the confluence of multiple modifiable and non-modifiable risk factors. The clinical importance of this pathology relies on the various syndromes that can develop from its etiopathogenesis, which generate great morbidity and mortality in affected individuals. In this document, we present three clinical cases of patients with SA in different aortic scenarios (aortic dissection, ulcerated plaques and thrombosed aneurysms) that denote the nature of this disease and its high mortality. Furthermore, we present an updated and detailed review of this entity, developing aspects of its pathophysiology, diagnosis, including the importance of multimodal imaging, and its therapeutic approach.