Impact of gender on in-hospital outcomes following contemporary percutaneous intervention for peripheral arterial disease.
BACKGROUND
Percutaneous peripheral arterial intervention (PPAI) has emerged as an effective and less invasive alternative to surgery for peripheral arterial disease (PAD), however, data on gender differences in outcome of PPAI, especially in the stent era, are limited. The purpose of this study was to assess the gender differences on in-hospital outcomes of patients undergoing PPAI.


METHODS
We analyzed data on 268 consecutive patients (women: 122; men: 146) who underwent PPAI for PAD between October 2001 and January 2004. A total of 405 lesions (women: 184; men: 221) were treated.


RESULTS
Background characteristics were similar except for less prevalent prior coronary intervention in women (18.0% versus 28.8%; p = 0.04), and more prevalent current smokers in women (22.1% versus 12.3%; p = 0.03). Upper extremities interventions were performed more often in women (9.2% versus 3.2%; p = 0.01). Procedure success was achieved in 89.3% of women and 89.7% of men (p = NS). In-hospital mortality was similar between women and men (1.6% versus 0.7%; p = NS). However, hemorrhagic complications occurred more frequently in women (7.4% versus 0.7%; p = 0.006). The blood transfusion rate was significantly higher in women (6.6% versus 0.7%; p = 0.013). Female gender was the only independent predictor of hemorrhagic complications (OR = 12.2; 95% CI = 1.39-111.1; p = 0.024).


CONCLUSIONS
Percutaneous intervention for PAD can be performed in women with similar success rates as in men, albeit with a greater than 10-fold higher risk of hemorrhagic complications.
Kawamura
Akio
A
Department of Cardiovascular Medicine, Lahey Clinic Medical Center, 41 Mall Road, Burlington, MA 01805, USA. akio.kawamura@lahey.org
Piemonte
Thomas C
TC
Nesto
Richard W
RW
Bilazarian
Seth D
SD
Riskalla
Nabila S
NS
Chauhan
Manish S
MS
D000368:Aged; D000800:Angioplasty, Balloon / Q000009:adverse effects / Q000379:methods; D001157:Arterial Occlusive Diseases / Q000628:therapy*; D005260:Female; D005500:Follow-Up Studies; D006470:Hemorrhage / Q000453:epidemiology* / Q000209:etiology; D017052:Hospital Mortality; D006801:Humans; D015994:Incidence; D007297:Inpatients; D008297:Male; D016491:Peripheral Vascular Diseases / Q000628:therapy*; D012189:Retrospective Studies; D012737:Sex Factors; D016896:Treatment Outcome