摘要慢性主动脉夹层（CAD）常伴随假腔持续灌注及真腔受压闭塞，可引发主动脉瘤样扩张及增加多次干预的风险。尽管胸主动脉腔内修复在急性期主动脉夹层中疗效显著，但对慢性期夹层重塑效果有限。医师改装支架移植物现已成为处理CAD的重要手段之一，但由于术者经验差异和病变解剖的异质性，目前在治疗区段和整体规划方面尚缺乏系统化的框架。为应对这一挑战，本中心提出内脏区腔内修复（V-EVAR）策略，将包括内脏区和毗邻节段的主动脉作为独立治疗靶区，依据美国血管外科学会/美国胸外科医师学会推荐的0～11区主动脉解剖分区，将6～8区界定为内脏区核心，5区与9区作为上下游锚定/衔接区，以此规范术前测量与锚定长度设计，在实现重建主动脉及腹腔干、肠系膜上动脉和双肾动脉的同时，还能确保远近端的衔接锚定区。本文将通过两例病例的实践应用展示V-EVAR策略在CAD整体治疗规划中的可行性及优势。

abstractsChronic aortic dissection (CAD) is often characterized by persistent false lumen perfusion and true-lumen compression or occlusion, which can lead to aneurysmal degeneration and increase the need for repeated interventions. Although thoracic endovascular aortic repair provides significant therapeutic benefits in acute aortic dissection, its capacity to promote aortic remodeling in the chronic phase remains limited. Physician-modified endovascular grafts have emerged as an important treatment option for CAD. However, due to variability in operator experience and the heterogeneous anatomical characteristics of the disease, a systematic framework for selecting treatment zones and planning the overall repair strategy is still lacking. To address this challenge, our center proposes the visceral-endovascular aortic repair (V-EVAR) strategy, which regards the visceral aortic segment and its adjacent zones as an independent therapeutic target. Based on the Society for Vascular Surgery/Society of Thoracic Surgeon-recommended 0–11 aortic zone classification, zones 6–8 are defined as the visceral core, whereas zones 5 and 9 serve as the proximal and distal anchoring/transition zones. This framework standardizes preoperative measurements and anchoring-length design, enabling reconstruction of the aorta together with the celiac artery, superior mesenteric artery, and bilateral renal arteries, while ensuring adequate proximal and distal landing zones. This article illustrates the feasibility and advantages of the V-EVAR strategy in the overall management of CAD through two representative clinical cases.