Gender Related Long-Term Differences After Open Infrainguinal Surgery for Critical Limb Ischemia

Abstract

one in Switzerland. The median age of the patients was 41 years, and 16% were women. Demographic, procedural, and outcome data were collected and reviewed retrospectively. The patients were followed up during 2013-2014.Results: Early (30 day) mortality was 9% (7 patients), with only two cases directly related to the aortic injury; in hospital mortality was 14% as three patients died during the primary hospital admission within the first 6 months. Most patients had sustained severe injuries to other organ systems, and among all in hospital deaths brain injury was the predominant cause. Five year survival in the whole group was 81%. Re-intervention was needed in 16% (12 patients) during the first year, half of them within the first month. Only one patient underwent re-intervention more than 1 year after the initial procedure. Infolding and partial stentgraft collapse was the reason for the secondary procedure in five of the 13 patients; in three it occurred within 3 weeks of the acute TEVAR.Conclusion: TEVAR allows rapid and effective therapy in trauma patients with blunt aortic injury. The outcome is dependent on the severity of the concomitant injuries. The treatment is durable during the first decade after the procedure, but even longer follow up is needed to determine the impact of TEVAR in young patients on the degenerative changes that take place in the aging aorta. JOURNAL OF VASCULAR SURGERY

The effect of gender on outcomes after lower extremity revascularization

“…9,14 Women are also known to present with more advanced disease and are more likely to delay treatment. 13,18,54 This may translate to more extensive revascularizations with compromised run-off. Unfortunately, anatomic details were often missing from the included studies and could not be assessed.…”

“…After study screening by two authors, we included 40 studies from 39 articles in the quantitative analysis. [9][10][11][12][13][14][15][16][17][18][19][20] Lo et al 14 included two different patient populations, and these were treated as separate studies for the purposes of data pooling. The detailed selection process is shown in the PRISMA diagram (Fig 1).…”

“…On the one hand, a large number of studies have demonstrated significant gender-related differences in outcomes after peripheral vascular interventions. [9][10][11][12][13][14][15] On the other hand, studies have reported similar clinical outcomes between women and men. [16][17][18][19][20] The aim of this systemic review and meta-analysis was to investigate the gender-related short-term and long-term clinical outcomes after peripheral vascular intervention by pooling studies that reported differences between men and women after lower limb revascularization.…”

Peripheral Vascular Disease in Women: Therapeutic Options in 2019

“…With regard to infrainguinal disease, there are multiple conflicting results. In several observational studies for critical limb ischemia, surgical outcomes defined as MACE (including death), amputation, and a second intervention were identical for both sexes [61,62]. However, Lejay et al published their retrospective data in 2015 concluding that women were at higher risk of adverse events [63].…”

Cohort study of risk factors for 30-day readmission after abdominal aortic aneurysm repair

“…[21][22][23] There is also mounting evidence of the sex difference, however, as a contributing factor to cardiovascular events. 24,25 The gender disparity in vascular surgery is apparent in many different vascular disorders, especially carotid stenosis, [26][27][28] peripheral arterial disease, 29 and aneurysmal disorders. 30 Chung et al review a single institution's experience with EVAR from 1992 to 2012 and describe outcomes from 214 repairs in female patients.…”