One of the two patients was a 43-year-old middle-aged male, and the other was a 69-year-old elderly patient with pulmonary diseases such as senile bronchial disease and emphysema. If general anesthesia with conventional tracheal intubation was used, serious pulmonary complications were likely to occur after surgery. After careful discussion between our vascular surgery department and the anesthesiology department, we decided to perform the current world’s most advanced technique for the patient – endoluminal isolation of thoracic aortic coarctation under local anesthesia. The left common femoral artery was exposed under local infiltration anesthesia at the left inguinal incision, and the overlapping stent was placed through the common femoral artery incision. The entire operation lasted about 45 minutes, and the patient remained completely awake. After the operation, the advantage of local anesthesia was highlighted, and the patient recovered rapidly without any pulmonary complications. Aortic dissection is a tear in the aortic intima caused by the impact of blood flow, and the aortic blood flow enters the aortic wall through the intima, forming a hematoma in the aortic wall. It used to be called aortic dissecting aneurysm, but now it is referred to as aortic dissection because it is not an expansion of the aortic wall and is different from aortic aneurysm. The incidence of aortic dissecting aneurysm is about 5 to 10 cases per million population per year. The ratio of men to women is about 3:1, and the age of onset is mostly above 40 years. The Stanford classification method, which is commonly used internationally, classifies clips involving the ascending aorta as type A and the rest as type B type II. Aortic coarctation is an exceptionally aggressive condition, with a 24-hour survival rate of only 40%, a one-week survival rate of 25%, and a 3-month survival rate of only 10% after the occurrence of aortic coarctation. The prognosis for lesions involving the ascending aorta is even worse, with a 1-month survival rate of only 8%, while the 1-month survival rate for lesions involving only the thoracic descending aorta can be as high as 75%. In the past, the traditional open-heart surgery for aortic coarctation had the disadvantages of large trauma, slow recovery and high technical requirements. Since the 1990s, endoluminal techniques have been used internationally to treat aortic coarctation, which has brought a boon to patients suffering from this disease. In particular, aortic coarctation of the Standford B type has been largely overcome by vascular surgeons using endoluminal treatment. The majority of patients with aortic coarctation present with sudden, severe pain in the abdomen, chest, or back that is cut or torn and persistent until the aortic coarctation breaks through. The chest pain may radiate to the neck and arm, similar to acute myocardial infarction, and morphine-like drugs cannot reduce the pain. Abdominal pain is easily confused with acute abdomen, but cases of aortic coarctation rarely present with nausea, vomiting, abdominal pressure and abdominal muscle tension. Aortic wall dissection involving the ascending aorta may present with a diastolic heart murmur of aortic valve insufficiency. Those involving the subclavian, common carotid, and iliofemoral arteries may have a localized vascular murmur, with decreased or absent ipsilateral pulses and blood pressure. Lesions involving the cerebral vessels may be confused with cerebral hemorrhage or cerebral thrombosis due to hypertension. Intercostal artery involvement may result in sudden paraplegia. Hypertension has an adverse effect on the condition by accelerating the process of aortic wall dissection, exacerbating pain and contributing to early death due to hemopericardium, hemothorax, or mediastinal hemopericardium from clamping rupture. Therefore, cases of proposed aortic coarctation should be treated before the diagnosis is confirmed by aortography. Drugs are given to lower blood pressure, reduce peripheral vascular resistance and decrease left ventricular contraction so that the aortic wall dissection does not expand.