Key result
TEVAR yields favorable short-term outcomes but requires careful follow-up due to increasing re-intervention risk.
This review highlights that while TEVAR is a highly recommended, minimally invasive treatment for thoracic aortic diseases, its long-term efficacy is challenged by the need for re-interventions.
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Supports expanding TEVAR use in Japan; leaves open questions on long-term outcomes in broader populations.
Thoracic endovascular aortic repair has revolutionized the treatment of thoracic aortic diseases. It is now indicated not only for descending aortic aneurysms but also for acute and chronic type B dissections and blunt thoracic aortic injuries. In addition, the scope of treatment is expanding. The thoracic aortic stent graft has been on the market in Japan for 15 years with good results, and the number of operations continues to increase. However, although stent grafts are highly recommended in Japanese and international guidelines for many aortic diseases, re-intervention increases over time in all disease groups. Careful follow-up is important because of morphologic changes and new complications after treatment. (This is a translation of Jpn J Vasc Surg 2024; 33: 73–77.)
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Kiyomitsu Yasuhara (2026) conducted a review in Thoracic aortic diseases (descending thoracic aortic aneurysm, aortic dissection, blunt thoracic aortic injury). Thoracic endovascular aortic repair (TEVAR) vs. Open repair or medical management was evaluated. Thoracic endovascular aortic repair provides favorable short-term outcomes for thoracic aortic diseases, but careful follow-up is necessary due to the increasing need for re-intervention over time.
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