Abstract: Objective Based on hemodynamic analysis, to investigate the cause of distal tear in Stanford type B aortic dissection after Thoracic endovascular aortic repair （TEVAR）. Methods A patient with type B aortic dissection was reexamined regularly with CTA at 1 month, 6 months, 12 months and 24 months after TEVAR. Based on the CTA images of four periods, four three-dimensional aorta models were reconstructed to perform morphological analysis and hemodynamic simulation. Results Compared with that at 1 month after TEVAR, the diameter of true lumen at 12 months after TEVAR increased by 1.8 times and the global distortion of aorta increased by 16.67%. At postoperative 1, 6 and 12 months, the maximum blood velocities at the new tear at systolic were 69.6%, 33.7% and 92.1% higher than the average ones at the distal landing zone, and the maximum wall shear stresses (WSSs) were 2.52,2.32 and 3.52 times of the average values respectively. In addition, the maximum time-averaged WSS (TAWSS) at 1, 6 and 12 months after TEVAR were 1.88, 2.53 and 3.62 times of the mean values respectively. Conclusions The morphology of the aorta remodeled following TEVAR, and a sudden change in the diameter of the true lumen occurred at the distal anchoring zone. As a result, the blood flow velocity in this area accelerated, and the intima was continuously exposed to high WSS, leading to a new distal tear.