Vascular Surgery in Japan: 2018 Annual Report by the Japanese Society for Vascular Surgery.

This is an annual report indicating the number and early clinical results of annual vascular treatment performed by vascular surgeons in Japan in 2018, as analyzed by database management committee (DBC) members of the Japanese Society for Vascular Surgery (JSVS). 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. In total, 143,745 vascular treatments were registered by 1,090 institutions in 2018. This database comprises seven 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 24,495, 18,700, 4,813, 2,363, 694, 45,088, and 47,592, respectively. In the field of aneurysm treatment, 20,160 cases of abdominal aortic aneurysm (AAA), including common iliac aneurysm, were registered, and 61.6% were treated by endovascular aneurysm repair (EVAR). Among AAA cases, 1,794 (8.9%) cases were registered as ruptured AAA. The operative mortality rates of ruptured and unruptured AAA were 15.7% and 0.6%, respectively. Approximately 43.3% of ruptured AAA were treated by EVAR, and the EVAR ratio was gradually increasing, but the operative mortality rates of open repair and EVAR for ruptured AAA were 14.0% and 14.6%, respectively. Regarding chronic arterial occlusive disease, open repair was performed in 8,336 cases, including 1,348 distal bypasses to the crural or pedal artery, whereas endovascular treatment (EVT) was performed in 9,710 cases. The EVT ratio was gradually increased at 51.9%. Varicose vein treatment was decreased in 43,133 cases (7.7% less than that in 2017), and 77.3% of the cases were treated by endovenous thermal ablation (ETA), including endovenous laser ablation (EVLA) and radiofrequency ablation (RFA). Regarding other vascular operations, 44,003 cases of vascular access operations and 1,631 lower limb amputation surgeries were included. The number of vascular treatments increased since 2017, and the proportion of endovascular procedures increased in almost all fields of vascular diseases, especially EVAR for AAA, EVT for chronic arterial occlusive disease, and ETA for varicose veins. (This is a translation of Jpn J Vasc Surg 2022; 31: 217-237.).