Percutaneous infrainguinal revascularization was performed on 309 women between 2001 and 2006. Procedures, complications, demographics, comorbidities, and follow-up data were entered into a prospective database for review. Patency was assessed primarily by duplex ultrasonography. Outcomes were expressed by Kaplan-Meier curves and compared by log-rank analysis.
A total of 447 percutaneous interventions performed in 309 women were analyzed and compared with 553 interventions in men. Mean age in women was 73.2 years; comorbidities included hypertension (HTN) (86 % ), diabetes melitus (DM) (58 % ), chronic renal insufficiency (CRI) (15 % ), hemodialysis (7 % ), hypercholesterolemia (52 % ), coronary artery disease (CAD) (42 % ), and tobacco use (47 % ). Indications in women included claudication (38.0 % ), rest pain (18.8 % ), and tissue loss (43.2 % ). Overall primary & secondary patency and limb-salvage rates for women were 38 % ± 4 % , 66 % ± 3 % , and 80 % ± 4 % at 24 months. In this patient sample, women were significantly more likely than men to present with limb-threatening ischemia (61.6 % vs 47.3 % , P < 0.001) and have lesions of TASC C and D severity (71.4 % vs 61.7 % , P < .005). However, there were no significant differences in primary and secondary patency rates or limb-salvage rates between genders. Furthermore, while women with limb-threat, diabetes, and advanced TASC severity lesions were at increased risk of failure overall, there were no differences between women and men with these characteristics.
Percutaneous infrainguinal revascularization is a very effective modality in women with lower extremity occlusive disease. Although women in this sample were more likely to present with limb-threat than men, patency and limb-salvage rates were equivalent between genders, even in high-risk subsets such as diabetics or those with lesions of increased TASC severity.