Midterm Results of Stenting of Femoropopliteal Lesions Using Interwoven Nitinol Stents

Abstract

Objectives: Women are under-represented in trials that set guidelines for aortic aneurysm management. Several studies reported inferior outcomes in women compared with men after endovascular aneurysm repair (EVAR). We investigated the relationship between gender and outcomes after EVAR.Methods: A total of 1380 consecutive patients underwent elective EVAR from 1992 to 2012. Baseline, intraoperative, and postoperative variables were analyzed from a prospective database.Results: The cohort consisted of 214 women (15.5%) and 1166 men (84.5%). Women were older than men at repair (77.8 vs 74.5 years; P < .001) and had less cardiac disease (P ¼ .005). They had shorter (19.8 6 12.9 mm vs 26.3 6 14.7 mm; P < .001), more angulated aortic necks (38.8 6 16.1 vs 31.2 6 14.7 ; P < .001) and fewer iliac aneurysms (P ¼ .002). Women had more arterial reconstructions (iliac conduits, P ¼ .006; thrombolysis and thrombectomy, P ¼ .013; patch angioplasty, P < .001; endarterectomy, P < .001), more perioperative complications (11.2% vs 6.3%; P ¼ .009), and in-hospital days (4.1 days vs 3.4 days; P ¼ .029). Perioperative mortality was equivalent (women: 2% vs men: 2.3%; P ¼ .73). Mean follow-up was 30.9 months. Women and men experienced equivalent endoleaks, arterial reinterventions, aneurysm-related deaths, and overall survival.Conclusions: Female gender is associated with more periprocedural complications; however, it does not affect long-term reinterventions or survival. Further studies are warranted to elucidate the effect of gender on outcomes. This data should be considered when selecting EVAR for men and women.