title: Endovascular aortic aneurysm repair with the Zenith AAA Endovascular Graft: does gender affect procedural success, postoperative morbidity, or early survival?
abstract: The purpose of this study was to analyze the effect of gender on deployment, early morbidity, and survival after endovascular aortic aneurysm repair (EVAR) using the Zenith Endovascular Graft. Data were obtained from the U.S. Multicenter Zenith Endograft trial and complemented with results from the Zenith female registry, including 40 women (10.9%) and 326 men (89.1%). Data analysis included preoperative medical risk factors, aneurysm morphology, deployment, and postoperative morbidity data, and 30-day and 1-year results. Preoperatively, women more often had experienced thromboembolic events (13% vs 4.3%; P = 0.04), but less angina pectoris (24% vs 49%; P = 0.002) or myocardial infarction (18% vs 38%; P = 0.01) compared with men. Women had more angulated aneurysm necks and narrower iliac arteries compared with men. Procedural success, cardiovascular, pulmonary, renal, bowel-related, neurologic, or other adverse events were comparable, as were 30-day and 1-year survival. Females experienced more wound dehiscences (5.0% vs 0.0%; P = 0.01) and open surgical conversions in the first year (5%) compared with men (0.31%) (P = 0.03). With more challenging aneurysm morphologies, women were found to be at a higher risk for conversion in the first year after EVAR using the Zenith endograft. This however does not translate into inferior survival or higher overall morbidity compared with men.
authors.affiliation: Section of Vascular Surgery, Mayo Clinic, Jacksonville, FL 32224, USA.
authors.forename: Matthias
authors.initials: M
authors.lastname: Biebl
authors.forename: Albert G
authors.initials: AG
authors.lastname: Hakaim
authors.forename: Beate
authors.initials: B
authors.lastname: Hugl
authors.forename: Warner A
authors.initials: WA
authors.lastname: Oldenburg
authors.forename: Ricardo
authors.initials: R
authors.lastname: Paz-Fumagalli
authors.forename: J Mark
authors.initials: JM
authors.lastname: McKinney
authors.forename: Roy
authors.initials: R
authors.lastname: Greenberg
authors.forename: Timothy
authors.initials: T
authors.lastname: Chuter
mesh_terms: D000367:Age Factors; D017544:Aortic Aneurysm, Abdominal / Q000000981:diagnostic imaging / Q000401:mortality / Q000601:surgery*; D001027:Aortography; D001807:Blood Vessel Prosthesis; D019917:Blood Vessel Prosthesis Implantation / Q000009:adverse effects / Q000379:methods*; D016022:Case-Control Studies; D002423:Cause of Death; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D015994:Incidence; D008297:Male; D011183:Postoperative Complications / Q000175:diagnosis / Q000401:mortality*; D011336:Probability; D011474:Prosthesis Design; D011475:Prosthesis Failure; D012016:Reference Values; D012189:Retrospective Studies; D018570:Risk Assessment; D012720:Severity of Illness Index; D012737:Sex Factors; D016019:Survival Analysis