Annals of vascular surgery · 2026
The Influence of Gender on the Outcomes of Revascularization for Aortoiliac Occlusive Disease.
СтатьяСравнительное исследованиеНазвание и аннотация: Перевод пока не подготовлен
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de Athayde Soares Rafael, Lorenzoni Gabriel Souza, Pinheiro Victor Galvão, Peixoto Aleixo Flávio Augusto, Dutra de Souza Matos Brenda, Pecego Christiano Scheltekenuff, Sacilotto Roberto
Аннотация
BACKGROUND: The objective of the present study was to assess the impact of gender on outcomes following endovascular treatment of AIOD, focusing on patency, limb salvage, reintervention rates, and survival.
METHODS: This retrospective cohort study of prospectively collected data included consecutive patients with AIOD who underwent aortoiliac angioplasty between January 2017 and January 2024. Two groups were analyzed: (1) female patients, (2) male patients. Eligible patients presented with critical limb-threatening ischemia or disabling claudication. Regression cox was performed to evaluate the factors related to primary patency, major amputation, and overall survival. Among several factors analyzed, covered versus bare-metal stents and common femoral endarterectomy were evaluated.
RESULTS: A total of 108 endovascular procedures were attempted. Technical success was achieved in 103 patients (95.4%), who comprised the study cohort. The female group predominated with 57 patients (55.3%) and the male group with 46 patients (44.7%). Arterial hypertension was the most prevalent comorbidity (79.6%), with higher prevalence at female group than male group (87.7% vs. 69.6%, P = 0.021), followed by dyslipidemia (63.1%), diabetes mellitus (54.4%), and ischemic heart disease (28.2%), with higher prevalence at male group than female group (65.3% vs. 34.5%, P = 0.005). Concomitant common femoral endarterectomy (CFE) was performed in 11 patients (10.7%; 13% male group and 8.8% female group; P = 0.48). The perioperative mortality rate was 11.7%, with no significant differences among groups (P = 0.82). Primary patency at 1,000 days was 80.1% at male group and 78.1% at female group (P = 0.43). Limb salvage rates at 1000 days were 95.5% at male group and 95.5% at female group, P = 0.57. Cox regression analysis identified bare-metal stent use as a predictor of reduced primary patency (HR 15.99, 95% CI 2.07-122.996; P = 0.008). Conversely, CFE was a protective factor for better primary patency (HR 0.123, 95% CI 0.020-0.778; P = 0.026).
CONCLUSION: In conclusion, female and male patients with AIOD submitted to endovascular treatment had similar outcomes regarding patency, limb salvage rates, overall survival, and freedom from target-lesion reintervention. Moreover, covered stent use was associated with higher primary patency and lower reintervention rates compared with bare-metal stents, and concomitant CFE was a protective factor for better primary patency.
METHODS: This retrospective cohort study of prospectively collected data included consecutive patients with AIOD who underwent aortoiliac angioplasty between January 2017 and January 2024. Two groups were analyzed: (1) female patients, (2) male patients. Eligible patients presented with critical limb-threatening ischemia or disabling claudication. Regression cox was performed to evaluate the factors related to primary patency, major amputation, and overall survival. Among several factors analyzed, covered versus bare-metal stents and common femoral endarterectomy were evaluated.
RESULTS: A total of 108 endovascular procedures were attempted. Technical success was achieved in 103 patients (95.4%), who comprised the study cohort. The female group predominated with 57 patients (55.3%) and the male group with 46 patients (44.7%). Arterial hypertension was the most prevalent comorbidity (79.6%), with higher prevalence at female group than male group (87.7% vs. 69.6%, P = 0.021), followed by dyslipidemia (63.1%), diabetes mellitus (54.4%), and ischemic heart disease (28.2%), with higher prevalence at male group than female group (65.3% vs. 34.5%, P = 0.005). Concomitant common femoral endarterectomy (CFE) was performed in 11 patients (10.7%; 13% male group and 8.8% female group; P = 0.48). The perioperative mortality rate was 11.7%, with no significant differences among groups (P = 0.82). Primary patency at 1,000 days was 80.1% at male group and 78.1% at female group (P = 0.43). Limb salvage rates at 1000 days were 95.5% at male group and 95.5% at female group, P = 0.57. Cox regression analysis identified bare-metal stent use as a predictor of reduced primary patency (HR 15.99, 95% CI 2.07-122.996; P = 0.008). Conversely, CFE was a protective factor for better primary patency (HR 0.123, 95% CI 0.020-0.778; P = 0.026).
CONCLUSION: In conclusion, female and male patients with AIOD submitted to endovascular treatment had similar outcomes regarding patency, limb salvage rates, overall survival, and freedom from target-lesion reintervention. Moreover, covered stent use was associated with higher primary patency and lower reintervention rates compared with bare-metal stents, and concomitant CFE was a protective factor for better primary patency.
Предметные рубрики MeSH
HumansMaleRetrospective StudiesFemaleVascular PatencyRisk FactorsAgedLimb SalvageTime FactorsSex FactorsIliac ArteryAmputation, SurgicalAortic DiseasesRisk AssessmentStentsArterial Occlusive DiseasesEndarterectomyTreatment OutcomeMiddle AgedAged, 80 and overAngioplastyIschemiaHealth Status Disparities