Abstract：Objective This study aims to summarize the clinical application progress of fenestration for endovascular treatment of aortic dissection (AD) involving left subclavian artery (LSA). Methods A total of 142 studies on fenestration and the treatment of AD before June 2023 were searched in Chinese and English databases such as CNKI, Wanfang Data, Weipu Data, and PubMed. After excluding studies with inconsistent content, unavailable original text, and repetitive content, 48 published papers in authoritative journals were included to summarize and analyze the research progress in fenestration for endovascular treatment of AD involving LSA. Results Fenestration has developed rapidly and is relatively mature. It has many advantages in the treatment of AD involving LSA and has been successfully applied to the treatment of patients with anatomical variations in the left vertebral artery originating from the aortic arch. However, difficulties in alignment are noted. Preoperative three-dimentional (3D) printing technology can effectively improve the success rate of the alignment of preprocedural fenestration. Conclusion Fenestration is one of many branch vessel reconstruction techniques. In the current environment where endovascular intervention is the main treatment for AD, fenestration has the advantages of less trauma, physiological and anatomical structure, and fewer complications. With the assistance of 3D printing technology, fenestration will have more room for development in the future.
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