Abstract
Juxtarenal aortic aneurysms (JAA) account for approximately 15% of abdominal aortic aneurysms. Fenestrated endovascular aneurysm repair (FEVAR) and chimney endovascular aneurysm repair (CH-EVAR) are both effective methods to treat JAAs, but the comparative effectiveness of these treatment modalities is unclear. We searched the PubMed, Medline, Embase, and Cochrane databases to identify English language articles published between January 2005 and September 2013 on management of JAA with fenestrated and chimney techniques to conduct a systematic review to compare outcomes of patients with juxtarenal aortic aneurysm (JAA) treated with the two techniques. We compared nine F-EVAR cohort studies including 542 JAA patients and 8 CH-EVAR cohorts with 158 JAA patients regarding techniques success rates, 30-day mortality, late mortality, endoleak events and secondary intervention rates. The results of this systematic review indicate that both fenestrated and chimney techniques are attractive options for JAAs treatment with encouraging early and mid-term outcomes.
Highlights
Endovascular techniques are less invasive methods of treating infrarenal abdominal aortic aneurysms (AAAs)1,2, especially for patients with severe comorbidities3,4
All of these patients were treated for juxtarenal aortic aneurysm (JAA) between January 2005 and July 2013
The present review compared the clinical outcomes of patients who underwent F-EVAR and the chimney/snorkel technique for treatment of juxtarenal aortic aneurysms
Summary
Endovascular techniques are less invasive methods of treating infrarenal abdominal aortic aneurysms (AAAs), especially for patients with severe comorbidities. The term juxtarenal aortic aneurysm (JAA) is routinely used to describe complex AAAs with very short proximal necks They represent almost 15% of all AAAs7–12. Fenestrated endografts were developed to treat patients with aneurysms with short proximal necks This technique was first introduced in 199916. Fenestrated grafts extend the proximal sealing zone from the infrarenal segment to the juxtarenal aorta using fenestrations (holes) in the graft or scallops (gaps in the upper graft fabric margin) to permit perfusion of the visceral vessels. This procedure can be performed with or without bridging stents.
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