Objective: To compare the clinical efficacy of fenestrated endovascular aneurysm repair (F-EVAR) and chimney endovascular aneurysm repair (Ch-EVAR) in treatment of abdominal aortic aneurysm. 
Methods: The controlled studies comparing F-EVAR and Ch-EVAR in treatment of abdominal aortic aneurysm published in English and Chinese were searched through online databases. The retrieval time was up to December 2018. After the data extraction of the included studies, NOS was employed for quality assessment. Meta-analysis was conducted by using RevMan5.1 software.
Results: Eight studies were finally included involving 466 patients, with 283 cases in F-EVAR group and 183 cases in Ch-EVAR group. A total of 909 vessels were involved in these processes. The results of Meta-analysis showed that in F-EVAR group compared with Ch-EVAR group, the incidence of type I endoleak was reduced (OR=0.35, 95% CI=0.13–0.94, P=0.04), but the presence of target organ injury was increased (OR=2.92, 95% CI=1.25–6.81, P=0.01), while no significant differences were observed in terms of technical success rate, vascular re-stenosis/re-occlusion rate, 30-d mortality and re-intervention rate (all P>0.05).
Conclusion: Both F-EVAR and Ch-EVAR are safe and effective treatments for abdominal aortic aneurysm. F-EVAR has relative low incidence of type I endoleak but relatively high prevalence of target organ damage. However, this result still needs to be verified by further studies.