J.Jpn. Surg. Soc.. 112(1): 32-37, 2011

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Feature topic

ENDOVASCULAR THERAPY OF ABDOMINAL AORTIC ANEURYSMS: PRESENT AND FUTURE STATUS IN JAPAN

Since the Ministry of Health, Labor, and Welfare approved Cook's Zenith AAA in 2006, endovascular repair of abdominal aortic aneurysms (AAAs) has become a widespread, acceptable alternative to traditional surgical intervention in Japan, although it lagged far behind Western countries in adopting this technique. The number of patients who undergo endovascular aortic aneurysm repair (EVAR) is now 3,000 annually and it is expected to exceed 4,000 in the near future, which means that more than half of patients with abdominal aortic or iliac arterial aneurysms will undergo EVAR. A paradigm shift has thus emerged in the field of AAA repair, in which surgical graft replacement was the gold standard for more than 50 years. EVAR is now under the strict control of the Japanese Committee for Stentgraft Management (JACSM), which was established by 10 societies related to endovascular therapy. This appears to be one of the reasons why the outcomes of EVAR in Japan are markedly better compared with those in other countries. EVAR has made it possible to treat high-risk patients because it does not require laparotomy. Therefore, patients who would have been observed without intervention in the past can now benefit from EVAR. In Japan, an extremely aged society, endovascular repair will become a much more common measure for the treatment of patients with AAA.

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