Objective      To summarize an approach for treatment of acute Debakey type Ⅰ dissection with emergency ascending aorta replacement and then selective stent-graft placement of descending aorta via arteria femoralis.       Methods      A total of 5 cases of acute Debakey type Ⅰ dissection with emergency ascending aorta replacement and then selective stent-graft placement of the descending aorta via arteria femoralis in our department were included from Jun 2008 to Feb 2011. Computed tomography angiography （CTA）was regularly carried out to monitor the ascending aorta and stent of descending aorta.       Results      The treatments of the 5 cases were successful with no severe complication

with extracorporeal circulation for 208 to 266 min （average 232 min），and aorta cross-clamp for 113 to 152 min （average 155 min）

and the recovery was uneventful. Follow-ups were carried out in the first month and third month after operation. With all the cases

CTA indicatedan unobstructed blood vessel prosthesis

non-displacement stand

and compressed false lumen of distal aorta.       Conclusion      As for patients with acute Debakey type Ⅰ dissection

it is a safe and effective application for emergency ascending aorta replacement and then selective stent-graft placement of descending aorta via arteria femoralis.