The history and current status of thoracic endovascular aneurysm repair in Japan.

Japan has a long and successful history of performing thoracic endovascular aneurysm repair (TEVAR). While commercial endovascular grafts were being used worldwide, Japan developed and distributed custom and semi-order made triple-branched one-piece grafts and fenestrated devices for the treatment of arch aneurysms. Historically, Japan also innovated and proposed hybrid procedures such as debranching with stent grafting to treat arch aneurysms and thoracoabdominal aneurysms. Since its introduction, Japan has been at the forefront of performing TEVAR for complicated acute aortic dissection and uncomplicated chronic aortic dissection for patients with predicted aortic enlargement. In this review, the authors discuss the many issues surrounding successful TEVAR, focusing on devices, operative methods, and prevention of complications.