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Endovascular stent grafting has emerged as an effective method for the treatment of complicated acute type B aortic dissections. In cases where access to the aorta cannot be established through the ileofemoral trunks, the axillary arteries are used as an alternative route. Often, however, these arteries are too small to accommodate the device sheath. We report the case of an 82-year-old female with complicated type B aortic dissection treated with deployment of an endovascular stent-graft through an 8 mm Dacron graft sewn to the innominate artery.