Patients with aortic disease who undergo traditional open surgery,especially when involving the arch and supra-arch branches,have a high rate of complications and mortality.Thoracic endovascular aortic repair(TEVAR)is the preferred treatment for patients with aortic arch disease.With the support of 3D printing technology,the in vitro pre-fenestration technique for covered stents can help with accurate positioning during TEVAR surgery,resulting in fewer perioperative complications and faster postoperative recovery.This article will provide a detailed introduction to the operational steps of treating aortic arch disease using the in vitro pre-fenestration technique for covered stents.