Gender-Related Differences in Iliofemoral Arterial Anatomy among Abdominal Aortic Aneurysm Patients

Tran, Kenneth; Dorsey, Chelsea; Lee, Jason T.; Chandra, Venita

doi:10.1016/j.avsg.2017.01.025

Cited by 26 publications

(20 citation statements)

References 11 publications

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“…This may relate to sex differences in responsiveness to antiplatelet and other therapies 17 . Second, women tend to have higher vascular complications from access site due to differences in the anatomy and the smaller size of ilio‐femoral arteries in women than men 18 . Although bleeding can be mitigated using the radial approach, in women, higher cross‐over rates to the femoral approach have been noted which may contribute to the higher bleeding rates in women versus men 19‐21 …”

Section: Discussionmentioning

confidence: 99%

Gender‐based outcomes of coronary bifurcation stenting: A report from the National Readmission Database

Ghaffar

Osman

Kheiri

et al. 2021

Cathet Cardio Intervent

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Background: There is a paucity of data focusing on women's outcomes after percutaneous coronary interventions (PCI) for coronary bifurcation lesions (CBLs).Methods: Patients who received PCI for CBLs in the context of acute coronary syndrome (ACS) during the period of 01 October 2015-31 December 2017, were identified from the United States National Readmission Database. The primary endpoint of this study was in-hospital major adverse events (MAEs). The secondary endpoints were in-hospital mortality, vascular complications, major bleeding, post-procedural bleeding, need for blood transfusion, severe disability surrogates (non-home discharge and need for mechanical ventilation), resources utilization surrogates (length of stay and cost of hospitalization), and 30-day readmission rate. A 1:1 propensity score matching was used to compare the outcomes between women and men.Results: A total of 25,050 (women = 7,480; men = 17,570) patients were included in the current analysis. After propensity score matching, women had higher in-hospital MAEs (7 vs 5.2%, p < .01), major bleeding (1.8 vs 0.8%, p < .01), post-procedural bleeding (6.1 vs 3.4%, p < .01), need for blood transfusion (6.4 vs 4.2%, p < .01), non-home discharges (10.2 vs 7.1%; p < .01), longer length of hospital stay (3 days [IQR 2-6] vs. 3 days [IQR 2-5], p < .01) and higher 30-day readmission rate compared to men (14.2 vs. 11.5%, p < .01).Conclusions: Among all-comers who received PCI for CBLs in the context of ACS, women suffered higher MAEs and 30-day readmission rates compared to their men' counterparts. The higher MAEs in the women were mainly driven by higher postprocedural bleeding rates and the need for blood transfusion.

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Section: Discussionmentioning

confidence: 99%

Gender‐based outcomes of coronary bifurcation stenting: A report from the National Readmission Database

Ghaffar

Osman

Kheiri

et al. 2021

Cathet Cardio Intervent

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“…Even the use of intra‐aortic balloon pump (IABP) which typically uses a smaller sheath compared to IPVADs has been associated with a higher risk of serious vascular complications among females 16 . Females often have smaller iliofemoral vessels compared to males, this difference persists even after adjusting for height, weight, and other comorbidities known to affect vascular anatomy, this could potentially account for the higher risk of complications among females 17 . As the innovation in device technology continues, a newer version of IPVADs is currently under investigation under the name Impella‐ECP (Expandable Cardiac Power).…”

Section: Discussionmentioning

confidence: 99%

Gender‐based outcomes of impeller pumps percutaneous ventricular assist devices

Syed

Ghaffar

Patel

et al. 2020

Cathet Cardio Intervent

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Background There is paucity of data focusing on females' outcomes after the use of impeller pumps percutaneous ventricular assist devices (IPVADs). Methods Patients who received IPVADs during the period of October 1st, 2015‐December 31, 2017, were identified from the United States National Readmission Database. A 1:1 propensity score matching was used to compare the outcomes between females and males. Results A total of 19,278 (Female = 5,456; Male = 13,822) patients were included in the current analysis. After propensity score matching and among all‐comers who were treated with IPVADs, females had higher in‐hospital major adverse events (MAEs) (38 vs. 32.6%, p < .01), mortality (31 vs. 28%, p < .01), vascular complications (3.3 vs. 2.1%, p < .01), major bleeding (7.8 vs. 4.8%, p < .01), nonhome discharges (21.6 vs. 16.3%; p < .01), and longer length of stay (7 days [IQR 2–12] vs. 6 days [IQR 2–12], p = .02) with higher 30‐day readmission rate compared to males (20.5 vs.16.4%, p < .01). Furthermore, among patients who received the IPVADs for high‐risk percutaneous coronary intervention (HRPCI), females continued to have worse MAEs, which was driven by high rates of major bleeding. However, among patients who received IPVADs for cardiogenic shock (CS) the outcomes of females and males were comparable. Conclusions Among all‐comers who received IPVADs, females suffered higher morbidity and mortality compared to males. Higher morbidity driven mainly by higher rates of major bleeding was seen among females who received IPVADs for the hemodynamic support during HRPCI and comparable outcomes were observed when the IPVADs were used for CS.

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“…Studies have found that despite relatively stable AAA repair rates, the use of EVAR has increased. 6,39,40,41 Furthermore, a 2018 study 42 showed that these rates have increased in populations known to have more challenging anatomy, including women and elderly patients. A 2018 study by Herman et al 43 of EVARs from 2005 to 2014 demonstrated IFU violations in 43.8% of patients undergoing elective EVAR and that non-IFU EVARs were associated with higher risk of graft-related adverse events (HR, 1.8; 95% CI, 1.05-3.10).…”

Section: Discussionmentioning

confidence: 99%

Comparison of Outcomes in Elective Endovascular Aortic Repair vs Open Surgical Repair of Abdominal Aortic Aneurysms

et al. 2019

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Gender-Related Differences in Iliofemoral Arterial Anatomy among Abdominal Aortic Aneurysm Patients

Cited by 26 publications

References 11 publications

Gender‐based outcomes of coronary bifurcation stenting: A report from the National Readmission Database

Gender‐based outcomes of coronary bifurcation stenting: A report from the National Readmission Database

Gender‐based outcomes of impeller pumps percutaneous ventricular assist devices

Comparison of Outcomes in Elective Endovascular Aortic Repair vs Open Surgical Repair of Abdominal Aortic Aneurysms

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