Patient Zhu***, male, 65 years old. Date of surgery: March 9, 2012. Surgeons: Song Zhigang, Xiang Bo, etc. The patient was admitted to the hospital with sudden chest and back laceration-like pain for 1 day. After admission, CTA examination of the aorta suggested a Standford A type aortic dissection with a rupture in the distal segment of the ascending aorta and a limited pseudolumen formed in the ascending aorta, and some thrombus had formed in the pseudolumen. After 3 days, the patient’s chest and back pain disappeared and the general condition was good. Twenty days after the onset of the disease, CTA of the aorta was repeated, and it was found that the distal segment of the ascending aorta still had residual entrapment, and a limited entrapment separation was also found at the beginning of the descending aorta. Due to the patient’s age and general condition, he could not tolerate surgical treatment, so a minimally invasive interventional approach was decided to repair the patient’s aortic lesion by implanting a clad stent in the ascending and descending aorta to close the clogged rupture. A 3-cm long incision was made in the patient’s right groin to expose the femoral artery, and a contrast catheter was punctured and implanted. A straight overlapping stent was implanted in the aortic arch and descending aorta to close the opening at the beginning of the descending aorta and to maintain the flow of blood through the innominate artery, the left common carotid artery and the left subclavian artery. The operation went well and the patient recovered well after the operation and was discharged on the 5th day. At 3 months after surgery, the patient was living and moving as normal. At 6 months, the aortic CTA was reviewed and the aortic coarctation was well closed with no endoleaks and complete thrombosis of the false lumen; the ascending aorta, aortic arch and descending aorta were well shaped, and the unnamed artery, left common carotid artery and left subclavian artery, which supply blood flow to the head, were flowing smoothly. Discussion: Type A aortic coarctation is an aortic coarctation with lesions involving the ascending aorta and the aortic arch, which has an aggressive onset and poor natural prognosis. Surgery is the preferred treatment for type A aortic coarctation, but it is highly invasive and has high postoperative complications and mortality. As a result, some patients of advanced age and poor preoperative health are unable to tolerate the trauma of surgery and are deprived of effective treatment, and have to be treated conservatively. Endoluminal repair is a new technique for treating aneurysms by implanting a clad stent in the patient’s aorta using a minimally invasive interventional approach, which is less invasive, has fewer complications, and results in faster patient recovery; this technique is currently used mostly for type B aortic coarctation and aortic arch descending aneurysms. Because the lesion of type A aortic coarctation often involves the three arterial vessels supplying the head, treatment with conventional endoluminal repair techniques will affect the blood supply to the head vessels, so it is difficult to be used for the treatment of type A aortic coarctation. However, for some patients with limited coarctation of the ascending aorta or the aortic arch who cannot tolerate surgery, a combination of “chimney” technique, “open window” technique or “hybridization” technique can be attempted. “However, the technical difficulty is very high and requires the surgeon to be skilled in minimally invasive interventional techniques, so there are not many cases of successful clinical treatment. The patient had a type A aortic coarctation confined to the ascending aorta, and the rupture was very close to the opening of the innominate artery, so if a straight tubular stent was implanted routinely, the blood supply to the innominate artery and the left common carotid artery would be affected, so we used an “open window” stent implantation method to close the rupture of the ascending aortic coarctation and implanted another straight tubular stent at the same time. The procedure was very successful, and the patient had good results on postoperative review. This successful case has gained experience in the application of minimally invasive endovascular repair for partial type A aortic coarctation.