Background:In type B aortic dissection, surgical correction should be warranted in cases with impending rupture, progressive pain and end-organ damage. However, this approach is still associated with a high mortality and morbidity rate, therefore, endoluminal stent-graft repair is considered as a less invasive alternative with acceptable immediate to mid-term clinical results for treatment of complicated type B aortic dissection. The object of study is to assess mid- to long-term clinical results of the endoluminal stent-graft repair in patient with type B aortic dissection. Methods: Retrospective analysis was done on 42 patients (average age: 57.3) who underwent stent-graft repair at our center from September of 1994 to March of 2005. The indications of case selection were progression of dissection despite adequate medical treatment, dynamic obstruction, intractable pain, aortic diameter of 6cm or more, continuous false lumen leakage in either acute or chronic presentation. Results: Median follow-up duration was 43 months. There was an absence of postprocedural mortality or paraplegia. Angiographic success, defined as immediate closure of entry site without significant endoleak, was obtained in 30/42 patients. Clinical success, defined as the complete obliteration of the false lumen at follow-up, was achieved in 28/42 patients with complete resolution of false lumen or thrombosis at proximal entry of descending thoracic aorta being achieved in 26 cases. Among the 27 patients who were followed up for at least 36 months, there was an absence of mortality. Of these patients, 10/27 patients demonstrated complications such as persistent type I endoleak, false lumen flow patency at distal portion of stent-graft, newly developed aortic dissection and saccular aneurysm corrected by surgical conversion, minor graft perforation, wound infection and slowly progressive aortic enlargement. Conclusions: The clinical outcomes of stent-graft repair of type B aortic dissection were acceptable with clinical success rate of 66.7%. Endoluminal stent-graft repair should be considered as a safe and effective treatment option of type B aortic dissection, particularly in patients with a high risk of surgical mortality or morbidity.