Ruptured acute type B aortic dissection is a life-threatening condition with a high mortality rate. Right hemothorax secondary to this condition is extremely rare. Herein, we report a successful treatment of a ruptured acute type B aortic dissection via thoracic endovascular aortic repair in a 45-year-old man who initially presented with right hemothorax. Contrast-enhanced computed tomography confirmed massive right hemothorax and acute type B aortic dissection in which the primary entry was located just below the left subclavian artery. Moreover, a possible rupture site in the descending aorta at the level of Th6 was identified. We then performed an endovascular aortic repair with left subclavian artery open surgical debranching. His postoperative course was uneventful. The patient did not have any complications at a 6-month follow-up.

破裂的急性 B 型主动脉夹层是一种危及生命的疾病，死亡率很高。继发于这种情况的右侧血胸极为罕见。在此，我们报告了一名 45 岁男性最初出现右侧血胸，通过胸主动脉腔内修复术成功治疗了破裂的急性 B 型主动脉夹层。对比增强计算机断层扫描证实右侧大量血胸和急性 B 型主动脉夹层，其中主要入口位于左锁骨下动脉正下方。此外，在 Th6 水平上确定了降主动脉中可能的破裂部位。然后我们进行了左锁骨下动脉开放手术脱支的血管内主动脉修复。他的术后过程平安无事。患者在 6 个月的随访中没有出现任何并发症。