Aortic dissection is a catastrophic condition characterized by sudden onset and high risk. Some patients with either Stanford type A or B aortic dissection will develop a chronic dissecting aneurysm after an acute stage, for which, open surgery will cause severe trauma. In recent years, endovascular repair which emerged as an alternative has achieved favorable clinical results. Using fenestrated stent-grafts for repair of distal tears of chronic aortic dissection has just been initiated, and has shown good short-term results. However, lack of good landing zone, narrow true lumen, and false lumen in the origin of the visceral branches are bottlenecks for this technology, and it faces many challenges in these respects. Some new ways of thinking, such as "opening", "chiseling", "dredging" and "expanding", will help to promote this technology.