A 72 years old man underwent hemiarch replacement for acute aortic dissection of Stanford type A at the age of 62 years. Entry remained at the aortic arch, and the false lumen was patent to the terminal aorta. After 10 years, his aortic aneurysm was enlarged to 55 mm. Redo total arch replacement and open stent graft was performed. False lumen of thoracic descending aorta was thrombosed, but thoracoabdominal segment was patent. Two years later, he developed distal stent graft induced neo entry (dSINE). To achieve aortic reconstruction, thoracic endovascular aortic repair (TEVAR) of combined covered stent graft and metal bare stent was performed to the terminal aorta. Three months later, covered stent graft to left renal artery and coil emboli to false lumen, and abdominal endovascular aortic repair( EVAR) was performed. After these procedures, the false lumen was almost thrombosed.

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