Abstract: Objective：Observe the clinical efficacy and safety of TEVAR combined with fenestration in the treatment of Stanford type B aortic dissection.Methods：The clinical data of 81 patients with Stanford type B aortic dissection were analyzed in a prospective cohort study in our hospital from April 2012 to January 2017.According to different methods of reconstruction of the left subclavian artery，the patients were divided into the fenestration TEVAR group（n=47）and the hybrid TEVAR group（subclavian artery bypass grafting）（n=34）.The clinical characteristics，surgical conditions，complications and survival outcomes of the two groups were compared.Results：There was no death or paraplegia in either group.The mean operative time of the fenestration TEVAR group was（128±27）min，the mean length of hospital stay was（7.5±2.1）d，the incidence of postoperative pain was 17%.While data of the hybrid TEVAR group were （237±47）min，（13.3±3.6）d and 41.2%，respectively.In the fenestration TEVAR group，the incidence of proximal reverse dissection was 4.3%，the incidence of type Ia leakage was 6.4%，prospective incidence was 10.6%，incidence of renal insufficiency was 14.9%.While in the hybrid TEVAR group was 8.8%、11.8%、23.5%、20.6%，respectively.There was no statistically significant difference between the two groups（P>0.05）.Compared with the hybrid TEVAR group，the number，length and proximal and distal diameters of the scaffolds implanted in the windowed TEVAR group were not statistically significant（P>0.05）.The followup time was 36 months，and the followup rate was 90.1%.During the followup period，in the fenestration TEVAR group，the allcause mortality rate was 8.5%，the incidence of proximal reverse dissection was 4.3%the distal thoracic aorta distended was 14.9%，the incidence of intraoperative repair was 4.3%，and the incidence of aortic remodeling was 74.5%.In the hybrid TEVAR group，the data were 8.8%，5.9%，17.6%，2.9%，82.4%，respectively.Conclusion：Compared with the hybrid TEVAR group，the fenestration TEVAR group improved the longterm prognosis，did not increase the incidence of postoperative complications，shortened the operation time，hospital stay and reduced postoperative pain.Stanford type B aortic dissection may give preference to the fenestration TEVAR for preservation of LSA.

Key words: aortic dissection, left subclavian artery, thoracic endovascular aortic repair, fenestration