title: Endovascular chimney technique for juxtarenal abdominal aortic aneurysm: a systematic review using pooled analysis and meta-analysis.
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.
authors.affiliation: Clinical Division of Surgery, Department of Vascular Surgery, Chinese PLA General Hospital, Beijing, People's Republic of China.
authors.forename: Yue
authors.initials: Y
authors.lastname: Li
authors.affiliation: Department of Vascular Surgery, Peking University People's Hospital, Beijing, People's Republic of China.
authors.forename: Tao
authors.initials: T
authors.lastname: Zhang
authors.affiliation: Clinical Division of Surgery, Department of Vascular Surgery, Chinese PLA General Hospital, Beijing, People's Republic of China. Electronic address: WeiGuowger@163.com.
authors.forename: Wei
authors.initials: W
authors.lastname: Guo
authors.affiliation: Clinical Division of Surgery, Department of Vascular Surgery, Chinese PLA General Hospital, Beijing, People's Republic of China.
authors.forename: Chen
authors.initials: C
authors.lastname: Duan
authors.affiliation: Clinical Division of Surgery, Department of Vascular Surgery, Chinese PLA General Hospital, Beijing, People's Republic of China.
authors.forename: Ren
authors.initials: R
authors.lastname: Wei
authors.affiliation: Clinical Division of Surgery, Department of Vascular Surgery, Chinese PLA General Hospital, Beijing, People's Republic of China.
authors.forename: Yangyang
authors.initials: Y
authors.lastname: Ge
authors.affiliation: Clinical Division of Surgery, Department of Vascular Surgery, Chinese PLA General Hospital, Beijing, People's Republic of China.
authors.forename: Xin
authors.initials: X
authors.lastname: Jia
authors.affiliation: Clinical Division of Surgery, Department of Vascular Surgery, Chinese PLA General Hospital, Beijing, People's Republic of China.
authors.forename: Xiaoping
authors.initials: X
authors.lastname: Liu
mesh_terms: D000368:Aged; D017544:Aortic Aneurysm, Abdominal / Q000175:diagnosis / Q000401:mortality / Q000503:physiopathology / Q000601:surgery*; D019917:Blood Vessel Prosthesis Implantation / Q000009:adverse effects / Q000379:methods* / Q000401:mortality; D057510:Endovascular Procedures / Q000009:adverse effects / Q000379:methods* / Q000401:mortality; D005260:Female; D006801:Humans; D008297:Male; D011183:Postoperative Complications / Q000209:etiology; D012307:Risk Factors; D013997:Time Factors; D016896:Treatment Outcome; D014654:Vascular Patency