Background and Aims With the advancement of endovascular therapy, the treatment strategies for Stanford type B aortic dissection involving the left subclavian artery (LSA) have gradually matured. However, due to the complex anatomical structure of this area and the limitations of the devices themselves, complications such as endoleak, landing zone injury, and retrograde dissection still exist. This study explores the effectiveness of the Castor single-branched stent in treating Stanford type B aortic dissection through a single-center retrospective study.Methods Patients with Stanford type B aortic dissection who underwent endovascular surgery using the Castor single-branched stent in the Department of Vascular Surgery of the First Affiliated Hospital of Naval Medical University from December 2018 to October 2021 were included. Preoperative Dicom format full aortic CTA images, detailed intraoperative information, and follow-up outcomes of the included patients were collected. EndoSize software was used to measure variables such as the arterial diameter of the proximal and distal landing zones of the dissection, the length of the lesion, and the relationship between the LSA opening and the dissection. The stent enlargement rate was calculated based on the grafts used during surgery. The success rate of the surgery and the incidence rates of short- and long-term complications were observed and recorded.Results A total of 107 cases of Stanford type B aortic dissection were included, all of which were treated with endovascular surgery, achieving technical success in all cases. The distance from the main tear in the proximal dissection to the LSA was (42.7±17.3) mm; the distance from the proximal edge of the dissection to the LSA was (7.7±13.2) mm; the diameter of the proximal landing zone of the aorta was (31.5±3.0) mm; and the distance from the distal opening of the left common carotid artery to the proximal opening of the LSA was (8.5±2.6) mm. The proximal diameter of the main body of the Castor stent was (32.5±3.3) mm, the distal diameter was (26.6±3.3) mm, and the diameter of the branched stent was (10.7±3.5) mm. The proximal oversize of the main body stent was (3.2±3.5)%, and the distal oversize was (0.1±9.5)%. During the perioperative period and follow-up, 9 patients died. Among them, 1 patient died from multi-organ failure due to severe hypotension before surgery and low perfusion after operation; 1 patient died from retrograde dissection rupture 4 d after operation; 1 patient died from respiratory failure 1 month after operation; 1 patient died from pulmonary infection 4 months after operation; 2 patients died from heart failure 6 months after operation; 2 patients died from cerebral hemorrhage at 9 months and 14 months after operation respectively; and 1 patient died from an unknown cause 11 months after operation. Six patients experienced adverse events related to aortic dissection: 1 case of retrograde dissection and 3 cases of cerebral infarction occurred during the perioperative period; during follow-up, there was 1 case of type Ib endoleak and 1 case of branched stent occlusion.Conclusion Stanford type B aortic dissection often involves the LSA. Endovascular surgery requires anchoring the stent in a healthy landing zone while preserving the LSA to prevent complications such as cerebral infarction and paraplegia. The Castor single-branched stent is well-suited for endovascular treatment of Stanford type B aortic dissection involving the LSA and has certain advantages in treating those in the acute period.