摘要远端破口是Stanford B型主动脉夹层（TBAD）常见的解剖学表现，也是腔内修复术后假腔持续灌注和影响主动脉重构的“元凶”。对于TBAD远端破口的治疗，核心在于平衡干预风险与疾病进展危害，但何时干预及怎样干预，目前尚无统一的共识与指南。本文将结合基础与临床研究结果及笔者经验，探讨TBAD远端破口的处理时机与手术策略，为临床决策提供参考框架。

abstractsDistal entry tear is a common anatomical feature of Stanford type B aortic dissection (TBAD) and a key factor contributing to persistent false lumen perfusion after endovascular repair, which impairs aortic remodeling. The core of managing distal entry tears lies in balancing the risks of intervention against the hazards of disease progression; however, there remains no unified consensus or guideline regarding the optimal timing and approach for intervention. This article integrates basic and clinical research findings with the authors' experience to explore the intervention timing and surgical strategies for distal entry tear in TBAD, aiming to provide a reference framework for clinical decision-making.