目的　探讨肾动脉平面以上主动脉瘤 (AAARA)的治疗经验。方法　回顾性分析12 0例AAARA的临床资料。结果　夹层动脉瘤 84例 ,真性动脉瘤 2 7例 ,假性动脉瘤 9例。病变累及全程主动脉者 12例 ,主动脉弓 9例 ,胸降主动脉 2 0例 ,降胸至腹主动脉分叉部或以下 43例 ,胸腹主动脉 2 5例 ,涉及内脏动脉 11例。施行手术或支架型人工血管微创治疗74例。术中至术后 30d内死亡 11例 (14 9% )。术后并发症 9例 ,无截瘫、偏瘫或卒中发生。 16例腔内治疗病人中无严重并发症或死亡者。随访 48例 ,随访时间 1个月～ 15年 ,5例死亡 (10 4% )。保守治疗 46例中 ,44 1%死于瘤体破裂或其它严重并发症。结论　AAARA开胸手术仍存在着很大风险 ,而多种多样的支架型人工血管腔内置放和腔内开窗治疗有着良好前景 ,腔内血管外科技术将成为治疗AAARA的主流。 Objective To explore the treatment experience of aortic aneurysm (AAARA) above the renal artery. Methods The clinical data of 120 patients with AAARA were retrospectively analyzed. Results There were 84 cases of dissection aneurysm, 27 cases of true aneurysm, and 9 cases of false aneurysm. Twelve cases of lesions involving the entire aorta, 9 cases of aortic arch, 20 cases of thoracic descending aorta, descending to the abdominal aortic bifurcation or below 43 cases, 25 cases of thoracoabdominal aorta, involving 11 cases of visceral artery. Surgical or stent-graft minimally invasive treatment was performed in 74 cases. There were 11 cases (14 9%) died within 30 days after surgery. Postoperative complications occurred in 9 patients without paraplegia, hemiplegia, or stroke. There were no serious complications or deaths in 16 patients treated with endovascular therapy. Follow-up was performed in 48 patients. The follow-up period was from 1 month to 15 years. Five patients died (104%). Of the 46 cases treated conservatively, 44% died of rupture of the tumor or other serious complications. Conclusion There is still a great risk of open thoracic surgery in AAARA, and a variety of stent endovascular stent placements and endoluminal window treatments have good prospects. Endovascular surgical techniques will become the mainstream of AAARA treatment.