Sex Differences In Early Outcomes At Endovascular Repair For Infrarenal Abdominal Aortic Aneurysm
Boran Tumer, Goktan Askın, Bekir Bogachan Akkaya, Mehmet Karahan, Isa Civelek, Emre Kulahcıoglu, Hakkı Zafer İscan, Ertekin Utku Unal.
Ankara City Hospital, Ankara, Turkey.
Background Women are less likely to develop infrarenal abdominal aortic aneurysm (iAAA), however when they do, it is almost always associated with challenging anatomy, more rapid aneurysmal growth rate and earlier rupture. Women generally have poorer outcomes following open aneurysm repair; however, outcome is not well known after endovascular repair. This study aims to evaluate sex differences after elective endovascular aortic repair (EVAR) as a single center's experience. Methods A retrospective analysis of our database for patients undergoing EVAR procedure was performed. Between January 2013 and December 2019, 204 elective EVAR patients were evaluated. Patients were divided according to gender and all demographics, pre-peri-postoperative findings were compared. Eighteen were female (8,2%) with average age of 73,9±9,7 years which was older than the male population (p=0,030). Results According to demographic data, female population had statistically significant much more diabetes mellitus (p=0,048), hypertension (p=0,015), coronary artery disease (p=0,007), and coronary artery bypass grafting (p=0,015). Early mortality for female gender was also higher when compared to male gender (11,1% for women vs. 1,1% for men). In the follow up period of two years, there was no difference regarding to secondary interventions or procedure/aneurysm related complications. Conclusions When compared to open repair, female gender gives increased perioperative mortality also for endovascular treatment. That is surely because of challenging anatomy and the associated comorbidities. Small amount of patient population is a serious limitation for more comment. However, performing the endovascular treatment under instructions for use is much more important in female gender.
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