Vascular Surgery in Japan: 2017 Annual Report by the Japanese Society for Vascular Surgery

Abstract

Objectives: This is an annual report indicating the number and early clinical results of annual vascular treatment performed by vascular surgeon in Japan in 2017, as analyzed by database management committee (DBC) members of the JSVS. Materials and Methods: To survey the current status of vascular treatments performed by vascular surgeons in Japan, the DBC members of the JSVS analyzed the vascular treatment data provided by the National Clinical Database (NCD), including the number of treatments and early results such as operative and hospital mortality. Results: In total 137,909 vascular treatments were registered by 1,076 institutions in 2017. This database is composed of 7 fields including treatment of aneurysms, chronic arterial occlusive disease, acute arterial occlusive disease, vascular injury, complication of previous vascular reconstruction, venous diseases, and other vascular treatments. The number of vascular treatments in each field was 21,680, 18,123, 4,765 2,418, 669, 48,625 and 41,629, respectively. In the field of aneurysm treatment, 19,982 cases of abdominal aortic aneurysm (AAA) including common iliac aneurysm were registered, and 64.1% were treated by endovascular aneurysm repair (EVAR). Among AAA cases, 1,824 (9.1%) cases were registered as ruptured AAA. The operative mortality of ruptured and un-ruptured AAA was 15.0%, and 0.7%, respectively. 37.9% of ruptured AAA were treated by EVAR, and the EVAR ratio was gradually increasing, but the operative mortality of open repair and EVAR for ruptured AAA was 14.5%, and 12.3%, respectively. There was no statistical significance. Regarding chronic arterial occlusive disease, open repair was performed in 7,277 cases, including 1,348 distal bypasses to the crural or pedal artery, whereas endovascular treatment (EVT) was performed in 9,248 cases. The EVT ratio was gradually increased at 56.0%. The number of varicose vein treatments decreased to 46,754 (11.2% less than 2016), and 73.7% of the cases were treated by endovenous laser or radiofrequency ablations. Regarding other vascular operations, 38,769 cases of vascular access operations and 1,548 lower limb amputation surgeries were included. Conclusions: The number of vascular treatments increased since 2011, and the proportion of endovascular procedures increased in almost all field of vascular diseases, especially EVAR for AAA and EVT for chronic arterial occlusive disease.