Objective To evaluate the short-term clinical effectiveness and feasibility of thoracic endovascular aortic repair(TEVAR) with in situ laser fenestration.Methods 24 patients who received TEVAR and in situ laser fenestration from January 2017 to March 2017 were retrospectively reviewed.Include 24 patients,19 males,5 females,with an average age of (54.00 ± 13.58) years old.The clinical data,including post-operative symptoms,hospitalization days,the success rate,postoperative complications,30-day fatality ratio,the patency rate of branch stents,endoleak,etc.Results The mean hospitalization time was(12.81 ±4.18) days.32 aortic arch branch vessels were treated using in situ laser fenestration,30 succeed in laser fenestration,surgical success rate was 93.8％.One case with postoperative paraplegia recovered after treatment,another one with the left common carotid incision hematoma recovered too.The incidence of operation-related complications was 8.3 ％.After the surgery 1 patient died,30-day fatality ratio of 4.2％.Imaging surveillance with computed tomography angiography(CTA) was performed one month later after the operation,the patency rate of branch stents was 100％,one case was found endoleak.Conclusion For revascularizating aortic arch branch vessels during TEVAR,in situ laser fenestration has an excellent successful rate and short-term curative effect,while the long-term surveillance is needed.