Chen CK, et al. - This study was sought to investigate the relationship between the tortuosity of the targeted aortic segment (TAS) for stent-graft implantation and distal stent-graft–induced new entry (SINE) after thoracic endovascular aortic repair (TEVAR) for aortic dissection or intramural hematoma. A total of 70 individuals were included who underwent TEVAR using a single stent-graft between 2006 and 2016, and the tortuosity index of the TAS was estimated. The individuals were classified into high and low TAS tortuosity groups according to the median value of the tortuosity index. Between the two groups, the incidence of distal SINE was compared. After TEVAR, individuals with high TAS tortuosity have a higher incidence of distal SINE. In addition, more caution must be exercised during the follow-up of individuals with high TAS tortuosity after TEVAR.