Background and Aims Thoracic endovascular aortic repair (TEVAR) has gradually become a the first-line therapeutic option for thoracic diseases. However, hindered by the complex anatomical structure of the aortic arch, effectively reconstructing supra-arch arteries during lesion treatment is a common challenge when using current standardized products. Given this, our team, collaborating with a stent manufacturer, had developed the Castor customized fenestrated thoracic stent-graft (hereafter referred to as Castor customized fenestrated stent) and successfully performed the first case of Castor customized fenestrated stent implantation in China. This article provides a report on this.Methods The clinical data, stent customization details, and surgical procedure for the first case of Castor customized fenestrated stent implantation in China were described, and an analysis of the advantages and disadvantages of the Castor customized fenestrated stent and review of relevant literature were also conducted.Results The patient, a 59-year-old male who underwent TEVAR 14 years ago, developed an aortic arch aneurysm involving the left subclavian artery (LSA) and left common carotid artery (LCCA). With the patient's and family's consent, we utilized the Castor fenestrated stent to seal the aneurysm. The surgical plan involved using the Castor customized fenestrated stent to occlude the aneurysm and placing the Castor stent branch into the LCCA. Preoperatively, fenestrations were customized to separately reconstruct the innominate artery (IA) and LSA. Successful implantation of the Castor single branch stent was achieved during surgery, effectively reconstructing the three supra-arch arteries. Postoperative imaging confirmed satisfactory aneurysm occlusion with no endoleak, patent flow in the three branch arteries, and no occurrence of adverse events related to the aorta.Conclusion The performance of the Castor individualized fenestrated stent is excellent, fitting the patient's anatomical characteristics, completely isolating the aneurysm, and enabling precise fenestration for reconstruction of the supra-arch arteries. Importantly, it avoids compromising stent integrity, providing a means for precise clinical interventions.