Objective To analyze the clinical efficacy of left subclavian artery (LSA) revascularization combined with thoracic endovascular repair (TEVAR) in the treatment of Stanford type B aortic dissection (AD). MethodsA retrospective analysis was conducted on patients treated with TEVAR combined with LAS reconstruction surgery at Wuhan Central Hospital in Hubei Province from 2017 to 2021. The patients were divided into a reconstruction group and a simple stent group. The reconstruction group was subdivided into a hybrid reconstruction group and a chimney reconstruction group according to the different methods of reconstruction surgery. Perioperative data of different groups were compared. A total of 144 patients were included, including 108 males and 36 females. There were 113 patients in the simple group and 31 patients in the reconstruction group. There were statistically significant differences in surgical time, hospital stay, preoperative lesion area diameter, and postoperative right vertebral artery diameter between the reconstruction group and the simple group (P<0.05). There was no statistically significant difference in postoperative complications between the simple group and the reconstruction group within 1 year (P>0.05). There was no statistically significant difference in surgical time between different surgical procedures in the reconstruction group (P>0.05). During the follow-up period, there were no deaths. A total of 12 (10.6%) patients in the simple group experienced complications, which was lower than that in the reconstruction group (8 patients, 25.8%). Among them, the most common complication in the follow-up of patients in the simple group was internal leakage (5 patients), and there was no statistical difference compared to patients in the reconstruction group (2 patients). The most common complication in the follow-up of patients in the reconstruction group was hoarseness (2 patients), while in the simple group, 1 patient occurred. Conclusion Both different surgeries have good effects on the treatment of type B aortic dissection, and multi center, large sample, and long-term studies are needed.