title: The influence of gender on patency rates after iliac artery stenting.
abstract: OBJECTIVE
  The purpose of this study was to investigate the influence of gender on the long-term outcome after iliac artery stenting and to assess gender-specific differences of the influence of risk factors on treatment success and patency rates.
  
  
  METHODS
  Between January 2000 and December 2006, 404 percutaneous transluminal angioplasties with primary stent deployment for symptomatic iliac artery occlusive disease were performed at our center. These included 128 interventions in women and 276 interventions in men.
  
  
  RESULTS
  Whereas average age was significantly higher (65.9 ± 12.9 years; P = .007) and arterial hypertension more frequent (60.9% vs 49.3%; P = .032) in women, hyperuricemia (7.0% vs 14.1%; P = .047) and a positive smoking status (61.7% vs 74.3%; P = .014) were more frequently observed in men. Fontaine stage was more advanced (stages III and IV) in women than in men (P = .028; P < .001). Technical success was 97.7% in women and 99.3% in men. Overall complication rate was higher in women compared with men (P = .002), mostly caused by access site hematomas (4.7% vs 0.4%) and pseudoaneurysms (8.6% vs 2.5%). Patients were followed up for 45.0 ± 33.3 months. Restenosis developed in 16.8% of cases in women and in 14.6% of cases in men and was treated in 73.7% by an endovascular approach. Primary patency rates at 1, 3, 5, and 7 years were 90.3%, 77.2%, 60.2%, and 46.4% in women and 89.9%, 71.5%, 63.6%, and 59.7% in men, respectively (P = .524; log-rank, .406). Secondary patency rates were 97.2%, 91%, 81.5%, and 70.3% in women and 97.1%, 89.1%, 82.6%, and 78% in men, respectively (P = .959; log-rank, .003). Multivariate analysis identified lower age as the only independent risk factor for recurrent disease in both groups. Age-defined subgroup analysis showed a restenosis/reocclusion rate of 23.9% in men and 22.1% in women older than 63.5 years (P = .861) but 32.1% in men and 49.1% in women younger than that (P = .034).
  
  
  CONCLUSIONS
  Our data suggest that although women are older and present with a more advanced stage of peripheral arterial occlusive disease, endovascular therapy is equally effective irrespective of gender. Surprisingly, the subgroup of young female patients had a specifically poor outcome.
authors.affiliation: Department of Vascular Surgery, Medical University Innsbruck, Innsbruck, Austria. Electronic address: beate.hugl@i-med.ac.at.
authors.forename: Beate
authors.initials: B
authors.lastname: Bechter-Hugl
authors.affiliation: Department of Vascular Surgery, Medical University Innsbruck, Innsbruck, Austria; Department of Vascular and Endovascular Surgery, Wilhelminenspital, Vienna, Austria.
authors.forename: Jürgen
authors.initials: J
authors.lastname: Falkensammer
authors.affiliation: Department of Vascular Surgery, Medical University Innsbruck, Innsbruck, Austria.
authors.forename: Olaf
authors.initials: O
authors.lastname: Gorny
authors.affiliation: Department of Vascular Surgery, Medical University Innsbruck, Innsbruck, Austria; Department of Vascular Surgery, University Hospital Aachen, Aachen, Germany.
authors.forename: Andreas
authors.initials: A
authors.lastname: Greiner
authors.affiliation: Department of Radiology, Medical University Innsbruck, Innsbruck, Austria.
authors.forename: Andreas
authors.initials: A
authors.lastname: Chemelli
authors.affiliation: Department of Vascular Surgery, Medical University Innsbruck, Innsbruck, Austria.
authors.forename: Gustav
authors.initials: G
authors.lastname: Fraedrich
mesh_terms: D000368:Aged; D017130:Angioplasty / Q000379:methods*; D001157:Arterial Occlusive Diseases / Q000175:diagnosis / Q000503:physiopathology / Q000601:surgery*; D001317:Austria / Q000453:epidemiology; D005260:Female; D005500:Follow-Up Studies; D006083:Graft Occlusion, Vascular / Q000453:epidemiology*; D006801:Humans; D007083:Iliac Artery / Q000503:physiopathology / Q000601:surgery*; D015994:Incidence; D018810:Magnetic Resonance Angiography; D008297:Male; D008875:Middle Aged; D011184:Postoperative Period; D012189:Retrospective Studies; D018570:Risk Assessment; D012307:Risk Factors; D017678:Sex Distribution; D012737:Sex Factors; D015607:Stents; D013997:Time Factors; D018616:Ultrasonography, Doppler, Duplex; D014654:Vascular Patency