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Updated: Jul 11, 2026
Novel and Innovative Hybrid Technique for Type A Aortic Dissection
Published on: March 28, 2025
Endovascular chimney technique for juxtarenal abdominal aortic aneurysm: a systematic review using pooled analysis
1Clinical Division of Surgery, Department of Vascular Surgery, Chinese PLA General Hospital, Beijing, People's Republic of China.
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.
