J.Jpn. Surg. Soc.. 115(2): 65-70, 2014

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Feature topic

MID- AND LONG-TERM OUTCOME OF ENDOVASCULAR ANEURYSM REPAIR IN PATIENTS WITH ABDOMINAL AORTIC ANEURYSM

In Japan, endovascular aneurysm repair (EVAR) came into use later than in the USA. The Zenith AAA endovascular graft finally received regulatory approval in July 2006. Now, four systems, the Zenith, the Excluder, the Powerlink system, and Endurant stent graft have been approved for insurance reimbursement. The advantages of EVAR are that is a less-invasive procedure, involves little blood loss, and requires only a short time in surgery and short hospital stay. EVAR is indicated for older patients and those in poor general condition. On the other hand, the disadvantages of EVAR are anatomic restrictions and a higher reintervention rate than that after open surgery. Therefore, careful follow-up is required. The mid- and long-term results following the introduction of stent grafts in Japan are generally good compared with the outcome data reported in the European and US literature. The stent graft procedure spread safely following the introduction of new medical materials. Several studies showed the benefit of EVAR in reducing procedure-related mortality and morbidity rates after open aneurysm repair. The current good results of EVAR have shifted the choice toward the endovascular option. With the development of new devices and skillful techniques, the indications for EVAR will broaden. This review reports the mid- and long-term outcomes of EVAR and reviews the literature.

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