Yue Li1, Tao Zhang2, Wei Guo3, Chen Duan1, Ren Wei1, Yangyang Ge1, Xin Jia1, Xiaoping Liu1. 1. Clinical Division of Surgery, Department of Vascular Surgery, Chinese PLA General Hospital, Beijing, People's Republic of China. 2. Department of Vascular Surgery, Peking University People's Hospital, Beijing, People's Republic of China. 3. Clinical Division of Surgery, Department of Vascular Surgery, Chinese PLA General Hospital, Beijing, People's Republic of China. Electronic address: WeiGuowger@163.com.
Abstract
BACKGROUND: To evaluate the safety and efficacy of chimney endovascular abdominal aortic repair (Ch-EVAR) for juxtarenal abdominal aortic aneurysm. METHODS: Electronic literature published between 2003 and 2014 were searched from MEDLINE and EMBASE online databases. Inclusion criteria for articles included that more than 3 patients were enrolled, chimney graft techniques were used, and the basic outcomes, such as indications, mortality within 30-day or during follow-up, complications, endoleaks, and branch vessel patency were collected. The data were pooled for analysis. Meta-analysis was performed using Stata version 11 and heterogeneity was estimated using Cochrane Q statistic and I(2) statistic. RESULTS: In total, 12 electronic literature met the inclusion criteria and 236 patients (mean age, 73.9 years) undergone Ch-EVAR were collected. A total of 335 chimney grafts were implanted, including 288 to the renal arteries and 47 to superior mesenteric arteries. Mortality (<30 days) and mortality (during follow-up; a mean of 12 months) were 3.8% (9/236) and 10.6% (25/236), respectively. The rate of type I, II and III endoleaks during follow-up was 11.8% (28/236), 8.1% (19/236), and 0.4% (1/236), respectively. The chimney graft patency at 6 month was 96.6%. Meta-analysis showed that the rates of endoleaks (during follow-up), mortality (<30 days) and mortality (during follow-up) were 18%, 7% and 13%, respectively. CONCLUSIONS: Chimney graft is an efficient therapy with high initial technical success rate and favorable rates for perioperative outcomes.
BACKGROUND: To evaluate the safety and efficacy of chimney endovascular abdominal aortic repair (Ch-EVAR) for juxtarenal abdominal aortic aneurysm. METHODS: Electronic literature published between 2003 and 2014 were searched from MEDLINE and EMBASE online databases. Inclusion criteria for articles included that more than 3 patients were enrolled, chimney graft techniques were used, and the basic outcomes, such as indications, mortality within 30-day or during follow-up, complications, endoleaks, and branch vessel patency were collected. The data were pooled for analysis. Meta-analysis was performed using Stata version 11 and heterogeneity was estimated using Cochrane Q statistic and I(2) statistic. RESULTS: In total, 12 electronic literature met the inclusion criteria and 236 patients (mean age, 73.9 years) undergone Ch-EVAR were collected. A total of 335 chimney grafts were implanted, including 288 to the renal arteries and 47 to superior mesenteric arteries. Mortality (<30 days) and mortality (during follow-up; a mean of 12 months) were 3.8% (9/236) and 10.6% (25/236), respectively. The rate of type I, II and III endoleaks during follow-up was 11.8% (28/236), 8.1% (19/236), and 0.4% (1/236), respectively. The chimney graft patency at 6 month was 96.6%. Meta-analysis showed that the rates of endoleaks (during follow-up), mortality (<30 days) and mortality (during follow-up) were 18%, 7% and 13%, respectively. CONCLUSIONS: Chimney graft is an efficient therapy with high initial technical success rate and favorable rates for perioperative outcomes.
Authors: Martin Rabellino; Pedro N Moltini; Vanesa G Di Caro; Jose G Chas; Ricardo Marenchino; Ricardo D Garcia-Monaco Journal: World J Cardiol Date: 2017-07-26