Vascular Web Logo

SVS  SVS Foundation
A A A
VascularWeb

 PVSS14. Gender Differences in Aortic Aneurysm Presentation, Repair and Mortality in the VSGNE

​Ruby C. Lo1, Rodney P. Bensley1, Allen D. Hamdan1, Mark Wyers1, Elliot Chaikof1, Julie E. Adams2, Marc L. Schermerhorn1
1Vascular Surgery, BIDMC, Boston, MA; 2University of Vermont College of Medicine, Burlington, VT.

OBJECTIVES: Prior studies examining gender differences in AAA repair suggest there may be differences in presentation, suitability for EVAR, and outcomes between men and women.

METHODS: We used the Vascular Study Group of New England database to identify all patients undergoing EVAR or open AAA repair (OAR). We analyzed demographics, comorbidities, and procedural, and perioperative data. Results were compared using Fisher’s exact test.

RESULTS: A total of 4,193 patients underwent AAA repair (78% male, 54% EVAR). Women were less likely to undergo EVAR for intact aneurysms (50% vs. 60% of, p<.001) but not for ruptured aneurysms (27% vs. 21%, p=.25). Women were older (74 years vs. 72 years for intact, p<.001; 77.5 years vs. 73 years for rupture, p<.001) with smaller aortic diameters (56mm vs. 59mm for elective, p<.001; 71mm vs. 78mm for rupture, p=.005). Women had higher 30-day mortality after OAR for both intact (4% vs. 2%, p=.05) and rupture (48% vs. 33%, p=.03) repairs. However, 30-day mortality after EVAR was similar for both intact (1% in men vs. 1% in women, p=.58) and rupture (29% in men vs. 26% in women, p=1.00) repairs.

CONCLUSIONS: Women are undergoing EVAR at a higher rate than previously reported, being treated at older ages and smaller diameters, and rupture at smaller diameters than men. Thirty-day mortality is worse in women after OAR but comparable after EVAR.

AUTHOR DISCLOSURES: J. E. Adams, Nothing to disclose; R. P. Bensley, Nothing to disclose; E. Chaikof, Nothing to disclose; A. D. Hamdan, Nothing to disclose; R. C. Lo, Nothing to disclose; M. L. Schermerhorn, Endologix, Consulting fees or other remuneration (payment),Medtronic, Consulting fees or other remuneration (payment), Boston Scientific, Consulting fees or other remuneration (payment); M. Wyers, Nothing to disclose.

 
 
EVAR
OAR
 
 
Male (n=1,820)
Female (n=453)
p-value
Male (n=1,436)
Female (n=484)
p-value
Age (years), median
All
74
77
<.001
71
73
<.001
 
Intact
74
76
<.001
70
73
<.001
 
Ruptured
72
78
<.001
73
77
<.001
AAA diameter (mm), mean
All
58.4
56.6
.004
64.7
59.7
<.001
 
Elective
57.2
55.4
<.001
60.8
57.3
<.001
 
Symptomatic
65.4
62.5
0.39
69.3
65.4
.24
 
Ruptured
75.3
72.4
0.56
79.1
70.8
.004
30-day mortality (%)
All
2
2
0.46
8
9
.39
 
Intact
1
1
.58
2
4
.05
 
Ruptured
29
26
1.00
33
48
.03

Posted April 2012

Contact Us

Society for Vascular Surgery
633 North Saint Clair Street, 22nd Floor | Chicago, IL 60611
Phone: 312-334-2300 | 800-258-7188
Fax: 312-334-2320
Email: vascular@vascularsociety.org

Follow Us

YouTube

VascularWeb® is the prime source for all vascular health and disease information, and is presented by the Society for Vascular Surgery®. Its members are vascular surgeons, specialists, and vascular health professionals who are specialty-trained in all treatments for vascular disease including medical management, non-invasive procedures, and surgery.