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Database of Abstracts of Reviews of Effects (DARE): Quality-assessed Reviews [Internet]. York (UK): Centre for Reviews and Dissemination (UK); 1995-.

Database of Abstracts of Reviews of Effects (DARE): Quality-assessed Reviews.

Transrenal fixation of aortic stent-grafts: short- to midterm effects on renal function. A systematic review

Review published: 2006.

Bibliographic details: Sun Z, Stevenson G.  Transrenal fixation of aortic stent-grafts: short- to midterm effects on renal function. A systematic review. Radiology 2006; 240(1): 65-72. [PubMed: 16720868]

Quality assessment

The authors concluded that transrenal fixation appeared to be a safe alternative to infrarenal fixation of abdominal aortic aneurysm in the short- to midterm, but it was associated with a higher rate of renal infarction. Inadequate reporting of study design and quality, combined with the limitations of review methods, means that the authors' conclusions may not be reliable. Full critical summary


PURPOSE: To perform a systematic review of the short- to midterm effects of transrenal fixation of aortic stent-grafts on renal function in patients with abdominal aortic aneurysms.

MATERIALS AND METHODS: A search of the PubMed, MEDLINE, and EMBASE databases for English-language literature was performed. Studies with at least 10 patients were included for data analysis. Only studies on transrenal fixation of aortic stent-grafts that included follow-up results for renal function were included. A log-linear model was used for meta-analysis to compare transrenal fixation with infrarenal fixation.

RESULTS: Twenty-two studies met the inclusion criteria. Because two studies analyzed the same group of patients, one was excluded, for a total of 21 studies. Comparisons between transrenal fixation and infrarenal fixation were found in seven studies. For transrenal versus infrarenal fixation, the combined odds ratio, 95% confidence interval, and P value were found to be statistically significant with respect to postprocedural renal infarction only (combined odds ratio, 5.189; 95% confidence interval: 3.198, 8.420; P < .001). No significant difference was found between transrenal and infrarenal fixation with respect to renal dysfunction, renal artery occlusion, or endoleaks (P > .05).

CONCLUSION: Transrenal fixation of aortic stent-grafts seems to be a relatively safe alternative compared with infrarenal fixation in terms of short- to midterm follow-up. Postprocedural renal infarction, however, was significantly higher for transrenal fixation.

RSNA, 2006

CRD has determined that this article meets the DARE scientific quality criteria for a systematic review.

Copyright © 2012 University of York.

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