A new surgical method called the in-situ stent-graft fenestration (ISSF) technique is presented as an alternative for aortic arch reconstruction in type A aortic dissection. This technique offers shorter surgical durations and less intraoperative blood loss compared to the traditional Sun’s procedure. ISSF also results in lower in-hospital mortality rates and fewer postoperative complications. The six-month follow-up shows significant improvements in the dimensions of the aorta’s true and false lumens, suggesting promising short-term efficacy and safety.