Study designs of evaluations included in the review
Prospective and retrospective studies with 10 or more patients per treatment group were eligible for inclusion. Case reports and reviews were excluded. The duration of follow-up in the included studies ranged from 1 to 37 months.
Specific interventions included in the review
Studies that evaluated the repair of AAA using transrenal fixation were eligible for inclusion. The included studies used a variety of different types of stent-graft (details were provided). Some studies evaluated only transrenal fixation; others compared transrenal and infrarenal fixation, and one study compared transrenal fixation with open surgery.
Participants included in the review
Studies of patients with AAA were eligible for inclusion. Where reported, the mean age of the participants in the included studies ranged from 69 to 82 years. Some studies excluded patients with pre-operative renal insufficiency.
Outcomes assessed in the review
Studies that assessed renal function at regular intervals during follow-up were eligible for inclusion. Short-term effects were defined as less than 12 months and midterm as 12 to 36 months. The review assessed renal function/dysfunction, renal artery occlusion, renal infarction, endoleak and stent migration.
In the included studies, renal function was assessed by measuring biochemical levels (serum creatinine, urea nitrogen and glomerular filtration rate); studies agreed on definitions of renal dysfunction (definitions were reported). The patency of stent-covered arteries was most commonly assessed using helical computed tomography (CT) angiography; other studies used helical CT angiography plus duplex ultrasonography, or angiography and magnetic resonance angiography.
How were decisions on the relevance of primary studies made?
One reviewer selected the studies for inclusion.