The influence of gender on patency rates after iliac artery stenting

Bechter-Hugl, Beate; Falkensammer, Juergen; Gorny, Olaf; Greiner, Andreas; Chemelli, Andreas; Fraedrich, Gustav

doi:10.1016/j.jvs.2014.01.010

Cited by 44 publications

(28 citation statements)

References 26 publications

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“…139,159 Long-term outcomes may be inferior in younger (<50 years) patients, particularly women. 162 CFA interventions. Limited data are available to support the use of interventional therapy in occlusive disease of the CFAs, but several single-center experiences have been published, [163][164][165] presenting a technical success rate of nearly 90% and 1-year primary patency rate of 75%.…”

mentioning

confidence: 99%

Society for Vascular Surgery practice guidelines for atherosclerotic occlusive disease of the lower extremities: Management of asymptomatic disease and claudication

Conte

Pomposelli

Clair

et al. 2015

Journal of Vascular Surgery

704

508

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Peripheral arterial disease (PAD) continues to grow in global prevalence and consumes an increasing amount of resources in the United States health care system. Overall rates of intervention for PAD have been rising steadily in recent years. Changing demographics, evolution of technologies, and an expanding database of outcomes studies are primary forces influencing clinical decision making in PAD. The management of PAD is multidisciplinary, involving primary care physicians and vascular specialists with varying expertise in diagnostic and treatment modalities. PAD represents a broad spectrum of disease from asymptomatic through severe limb ischemia. The Society for Vascular Surgery Lower Extremity Practice Guidelines committee reviewed the evidence supporting clinical care in the treatment of asymptomatic PAD and intermittent claudication (IC). The committee made specific practice recommendations using the GRADE (Grades of Recommendation Assessment, Development and Evaluation) system. There are limited Level I data available for many of the critical questions in the field, demonstrating the urgent need for comparative effectiveness research in PAD. Emphasis is placed on risk factor modification, medical therapies, and broader use of exercise programs to improve cardiovascular health and functional performance. Screening for PAD appears of unproven benefit at present. Revascularization for IC is an appropriate therapy for selected patients with disabling symptoms, after a careful risk-benefit analysis. Treatment should be individualized based on comorbid conditions, degree of functional impairment, and anatomic factors. Invasive treatments for IC should provide predictable functional improvements with reasonable durability. A minimum threshold of a >50% likelihood of sustained efficacy for at least 2 years is suggested as a benchmark. Anatomic patency (freedom from restenosis) is considered a prerequisite for sustained efficacy of revascularization in IC. Endovascular approaches are favored for most candidates with aortoiliac disease and for selected patients with femoropopliteal disease in whom anatomic durability is expected to meet this minimum threshold. Conversely, caution is warranted in the use of interventions for IC in anatomic settings where durability is limited (extensive calcification, small-caliber arteries, diffuse infrainguinal disease, poor runoff). Surgical bypass may be a preferred strategy in good-risk patients with these disease patterns or in those with prior endovascular failures. Common femoral artery disease should be treated surgically, and saphenous vein is the preferred conduit for infrainguinal bypass grafting. Patients who undergo invasive treatments for IC should be monitored regularly in a surveillance program to record subjective improvements, assess risk factors, optimize compliance with cardioprotective medications, and monitor hemodynamic and patency status.

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mentioning

confidence: 99%

Society for Vascular Surgery practice guidelines for atherosclerotic occlusive disease of the lower extremities: Management of asymptomatic disease and claudication

Conte

Pomposelli

Clair

et al. 2015

Journal of Vascular Surgery

704

508

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“…Regardless of stent selection, operators must recognize the pretreatment risk factors predictive of late restenosis/occlusion which include: occlusion versus stenosis, longer lesions, external iliac over common iliac lesion location, and smaller arteries especially those with circumferential calcification . The long‐term patency of endovascular intervention of the aorto‐iliac arteries may differ by gender with lower patency rates in women, although this finding may reflect smaller vessel diameter .…”

Section: Methodsmentioning

confidence: 99%

SCAI appropriate use criteria for peripheral arterial interventions: An update

Klein

Jaff

Gray

et al. 2017

Cathet Cardio Intervent

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“…In 2014, cases of iliac-occlusive disease were examined for gender differences in outcomes and showed no difference in primary or secondary patency rates of iliac stenting based on gender, despite women having an older age at presentation and more extensive occlusive disease. 56 This suggests that women treated with iliac stenting may have similar outcomes than men when presenting with a greater burden of occlusive disease.…”

Section: Endovascular Treatment Of Pad: Gender and Technique Considermentioning

confidence: 99%

Gender Differences in Peripheral Vascular Disease

Schramm

Rochon

2018

Semin intervent Radiol

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In the past 20 years, peripheral artery disease (PAD) has been increasingly recognized as a significant cause of morbidity and mortality in the United States. PAD has traditionally been identified as a male-dominant disease; however, recent population trends and studies in PAD suggest that women are affected at least as often as men. Women comprise a larger population of the elderly than men, as well as an increasing proportion of patients with PAD. Much of the existing research on PAD has focused on whole populations, and gender-specific data on PAD is sparse. This review focuses on gender-specific differences in presentation, management, and outcomes of PAD intervention that are important considerations for the interventional radiologist.

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The influence of gender on patency rates after iliac artery stenting

Abstract: 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.

Cited by 44 publications

References 26 publications

Society for Vascular Surgery practice guidelines for atherosclerotic occlusive disease of the lower extremities: Management of asymptomatic disease and claudication

Society for Vascular Surgery practice guidelines for atherosclerotic occlusive disease of the lower extremities: Management of asymptomatic disease and claudication

SCAI appropriate use criteria for peripheral arterial interventions: An update

Gender Differences in Peripheral Vascular Disease

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