Abstract:Objective: To review the experience of endovascular treatment for Stanford type A aortic dissection with the entrance tear locating at the ascending aorta. Methods: The clinical data of 6 patients with Stanford type A aortic dissection an entrance tear at the ascending aorta who underwent ascending aortic stent-graft implantation or that combined with arch branch revascularization were retrospectively analyzed. Results: Procedures were successfully performed in all patients, of whom 4 cases underwent ascending aortic stent-graft implantation, and the other 2 cases underwent prosthetic carotid-carotid crossover bypass grafting prior to ascending aortic stent-graft implantation. After operation, acute cerebral infarction occurred in one case, acute myocardial infarction occurred in one case, and respiratory insufficiency occurred in two cases. One case died on postoperative day 1 due to hemorrhage from rupture of the aortic dissection, and the remaining cases were safely discharged. During 3- to 48-month follow-up, 2 cases developed type I endoleak, and were continuously followed-up without a second operation. Conclusion: For some high-risk patients who cannot tolerate traditional surgery, endovascular procedures by virtue of their minimal invasiveness can be used as an alternative approach to save their lives.