Aortic arch disease incidence is 2.6 for every million in Americans. It is much higher in Asia, however in Africa no records available .Aortic dissection incidence is 0.0001 of hospitalized patients; approximately 2000 newly reported cases yearly in the United States. (1) A type B aortic dissection (TBAD) accounts for 25-40% of aortic dissections, involving the aorta distal to the subclavian artery. Most of them (75%) are uncomplicated with no malperfusion or ischemia. Many consensus declarations recommend thoracic endovascular aortic repair (TEVAR) as the treatment of choice for acute complicated type B aortic dissections, while uncomplicated type B dissections are traditionally treated with medical management alone. However, with medical treatment alone, the morbidity, including aneurysm degeneration of the affected segment, is 30%, and mortality is 10% over 5 years. For both chronic and acute uncomplicated type B aortic dissections, growing evidence that supports the use of both best medical therapy and TEVAR.(2) Hybrid repair, which consists of arch debranching(complete or partial) and TEVAR, is a valid option for the treatment of complex aortic dissection and other aortic arch diseases. There are several types of hybrid repair with various arch debranching techniques have been reported to obtain the desired result,(3) . The management of TBAD by hybrid technique is considered demanding as less invasive management by heart lung machine. (4).