Delayed complications after endovascular AAA repair in women

Murray L. Shames, Luis A. Sanchez, Brian G. Rubin, Eric T. Choi, Patrick J. Geraghty, M. Wayne Flye, Robert W. Thompson, Gregorio A. Sicard

Research output: Contribution to journalArticle

16 Scopus citations

Abstract

Purpose: To assess whether women suffer more delayed complications or require more interventions after endovascular abdominal aortic aneurysm (AAA) repair. Methods: Over a 2-year period, 245 patients (203 men, 42 women) underwent endovascular repair with the AneuRx stent-graft at our institution. Baseline, operative, and follow-up data were reviewed and outcomes compared between men and women for complications or secondary procedures beyond the 30-day postoperative period. Results: The 42 (17.1%) women treated with the AneuRx graft experienced more technical complications (17% versus 8.3%; p<0.05) and acute conversions to open repair (6/7, 86%; p = 0.0005). At 30 days, systemic morbidity was significantly higher in women (26% versus 5.3%; p = 0.001.) However, mortality (2.3% versus 1.5%), length of hospital stay (2.6 versus 2.9 days), and major endoleaks at discharge (0% versus 1.6%) were similar. Over a mean follow-up of 11.3 months (range 1-26), graft limb occlusion occurred more frequently in female patients (12.2% versus 2.5%; p = 0.05), and secondary procedures were required in a significantly higher number of women (29% versus 9%; p<0.05). Three patients in each group (25% of women versus 17% of men) who had secondary procedures required additional interventions. Although not statistically significant, the mortality in women during follow-up was higher (9.7% versus 5%); 2 deaths were directly related to graft complications in the female group. Conclusions: Endoluminal AAA repair in women presents a technical challenge at the time of operation and may cause more frequent late complications, necessitating close post-procedural surveillance and prompt correction of complications to avoid potentially catastrophic outcomes. Reassessment of inclusion criteria for women may be necessary.

Original languageEnglish
Pages (from-to)10-15
Number of pages6
JournalJournal of Endovascular Therapy
Volume10
Issue number1
DOIs
StatePublished - Feb 1 2003
Externally publishedYes

Keywords

  • Abdominal aortic aneurysm
  • AneuRx stent-graft
  • Endovascular repair
  • Gender differences
  • Late complications
  • Outcome analysis
  • Secondary interventions

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