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lüll Transrenal fixation of aortic stent-grafts: short- to midterm effects on renal function--a systematic review Sun Z; Stevenson GRadiology 2006[Jul]; 240 (1): 65-72PURPOSE: 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.|*Postoperative Complications/epidemiology[MESH]|Aged[MESH]|Aged, 80 and over[MESH]|Aortic Aneurysm, Abdominal/*surgery[MESH]|Blood Vessel Prosthesis Implantation/*adverse effects/methods[MESH]|Creatinine/blood[MESH]|Evidence-Based Medicine[MESH]|Humans[MESH]|Kidney Diseases/epidemiology/*etiology[MESH]|Linear Models[MESH]|Renal Artery[MESH]|Stents/*adverse effects[MESH] |