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Home > Vascular Annual Meeting > PVSS6. How Gender Affects the Outcome of Endovascular...

PVSS6. How Gender Affects the Outcome of Endovascular Repair of Abdominal Aortic Aneurysms

Clifford J. Buckley, MD, FACS; Christopher J. Marrocco, MD; Ruth L. Bush, MD, MPH, FACS; William T. Bohannon, MD; Marvin D. Atkins, MD; Shirley Buckley, MSN, RN, CS
Scott & White Memorial Hospital Texas A&M University, Temple, TX

OBJECTIVES: Reports vary as to the influence of gender on the outcome of endovascular repair of abdominal aortic aneurysm (EVAR). In an effort to provide additional information on this subject, we analyzed data from 449 consecutive single center EVAR cases treated over 8 years.
 
METHODS: In an Institutional Review Board approved study, the clinical data for 449 patients prospectively enrolled in an aortic aneurysm data base who underwent EVAR at Scott and White Hospital and Clinic between Aug 2000 and Aug 2008 was retrospectively reviewed. Sixty five patients were female and 384 patients were men. Demographics, co-morbidities, patient survival, aneurysm rupture, presence and type of endoleak, and need for secondary interventions were assessed collectively and with respect to each of the FDA approved aortic endografts. Kaplan-Meier, Cox-Mantel log-rank and Chi square methods were used for statistical analyses.
 
RESULTS: Female patients were slightly older than males (71±6yrs vs. 69±8yrs). Mean aneurysm size was 5.7 cm (4.8-6.9 cm) for females and 5.9cm (4.2-14 cm ) for males. Follow-up ranged from 1 to 96 months for both groups; mean follow-up was 28.94±22.2 months for females and 30.04±24.2 months for males. Co-morbidities were similar for both females and males except renal insufficiency; severe obesity and COPD were slightly less common in females. Peri-operative mortality was 1.5% for both (1/65 females and 6/384 males). Survival was 75% for females and 79.9% for males (p=ns). Endoleaks: TypeI 1/65 female and 6/384 males; Type II 5/65 females and 46/384 males; Type III 1/65 female and 0 male (p=ns for all). Limb occlusions: 1/65 female and 5/384 males (p=ns). Secondary intervention rate 6.2% female and 3.1% male (p=ns) There were no ruptures in either group and no statistically significant difference in endograft performance. Conversions: early 1/65 females and 3/384 males; 0 late.
 
CONCLUSIONS: Female gender has no significant effect on outcome for EVAR in this series. Following IFU guidelines and selecting the best endograft appropriate for the patient’s arterial anatomy are the best predictors for good outcome.

AUTHOR DISCLOSURES: C.J. Buckley, None; C.J. Marrocco, None; R.L. Bush, Endologix, Medtronic; W.T. Bohannon, None; M.D. Atkins, None; S. Buckley, None.