Fenestrated Endografts Versus Chimney Stent Repair For Abdominal Aortic Aneurysms:A Meta-analysis

Objective:To compare the clinical efficacy of fenestrated endovascular aneurysm repair(F-EVAR)and chimney endovascular aneurysm repair(Ch-EVAR)in treatment of abdominal aortic aneurysm(AAA).Methods:The controlled studies comparing F-EVAR and Ch-EVAR in treatment of AAA published in English and Chinese were searched through online databases.The retrieval time was up to December2018.After the data extraction of the included studies,Newcastle-Ottawa Scale(NOS)was employed for quality assessment.Meta-analysis was conducted by using RevMan5.1software.Results:Eight studies were finally included involving 466 patients,with283 cases in F-EVAR group and 183 in Ch-EVAR group.A total of 909 vessels were involved in these processes.The results of Meta-analysis showed that in F-EVAR group compared with Ch-EVAR group the incidence of type I endoleak was reduced(OR=0.35,95%CI=[0.13,0.94],P=0.04),while the target organ dysfunction rate was increased(OR=2.92,95%CI=[1.25,6.81],P=0.01),technical success(P=0.29),vascular restenosis/occlusion rate(P=0.38),30-day mortality(P=0.09),as well as the re-intervention rate(P=0.26)showed no significant difference.Conclusions:A higher rate of type I endoleak was observed in Ch-EVAR group while F-EVAR group was associated with a higher target organ dysfunction rate,with similar technical success rate,vascular restenosis/occlusion rate,30-day mortality and the re-intervention rate.F-EVAR and Ch-EVAR were safe and effective in treating patients with abdominal aortic aneurysm,especially in high risk patients.However,this result still needs to be verified by further studies.