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Sex disparities in popliteal artery aneurysms.
Leinweber, Maria-Elisabeth; Geisbuesch, Phillip; Balzer, Kai; Schmandra, Thomas; Karl, Thomas; Popp, Sebastian; Hoffmann, Johannes; Schmitz-Rixen, Thomas; Jung, Georg; Oikonomou, Kyriakos; Storck, Martin; Balzer, Kai; Kugelmann, Ulrich; Schneider, Christina; Engelhardt, Michael; Petzold, Michael; Weis-Mueller, Barbara; Wortmann, Markus; Popp, Sebastian; Grotemeyer, Dirk; Wenk, Heiner; Shayesteh-Kheslat, Roushanak; Torsello, Giovanni; Böckler, Dittmar; Meisenbacher, Katrin; Hoffmann, Johannes; Schelzig, Hubert; Roopa, Yush; Strohschneider, Thomas; Noppeney, Thomas; Reichert, Viktor; Lorenz, Uwe; Pfister, Karin; Damirchi, Shoaeddin; Stojanovic, Tomislav; Oberhuber, Alexander; Lobenstein, Bernd; Sagban, Tolga Atilla; Pfeiffer, Tomas; Koller, Johann; Sprenger, Christian; Kruschwitz, Thomas; Schmedt, Claus-Georg; Marquardt, Frank; Schmandra, Thomas; Bail, Dorothee.
Afiliación
  • Leinweber ME; Department of Vascular and Endovascular Surgery, Clinic Ottakring, Vienna, Austria. Electronic address: Mariaelisabeth.leinweber.reply@gmail.com.
  • Geisbuesch P; Department of Vascular and Endovascular Surgery, Klinikum Stuttgart, Stuttgart, Germany.
  • Balzer K; Department of Vascular and Endovascular Surgery, St. Marien-Hospital, GFO-Kliniken, Bonn, Germany.
  • Schmandra T; Department of Vascular Surgery, Sana Klinikum Offenbach, Offenbach, Germany.
  • Karl T; Department of Vascular and Endovascular Surgery, Klinikum am Plattenwald, SLK-Kliniken Heilbronn GmbH, Bad Friedrichshall, Germany.
  • Popp S; Department of Vascular Surgery, RoMed Klinik Wasserburg am Inn, Wasserburg am Inn, Germany.
  • Hoffmann J; Department of Vascular Surgery and Phlebology, Contilia Herz und Gefaeßzentrum, Essen, Germany.
  • Schmitz-Rixen T; German Society of Surgery, Langenbeck-Virchow-Haus, Berlin, Germany.
  • Jung G; Department of Vascular and Endovascular Surgery, Lucerne Cantonal Hospital, Lucerne, Switzerland.
J Vasc Surg ; 79(5): 1179-1186.e1, 2024 May.
Article en En | MEDLINE | ID: mdl-38145634
ABSTRACT

OBJECTIVE:

Only 5% of patients with popliteal artery aneurysms (PAAs) are female. Evidence on PAA treatment and outcomes in women is therefore scarce. The POPART Registry provides one of Europe's largest data collections regarding PAA treatment. Data on clinical presentation, aneurysm morphology, and perioperative outcomes after open surgical PAA repair in women will be presented.

METHODS:

POPART is a multicenter, noninterventional registry for open and endovascular PAA repair, with 42 participating centers in Germany and Luxembourg. All patients aged >18 years who have been treated for PAA since 2010 are eligible for study inclusion. Data collection is based on an online electronic case report form.

RESULTS:

Of the 1236 PAAs, 58 (4.8%) were in women. There were no significant differences in age or cardiopulmonary comorbidities. However, female patients had a lower prevalence of contralateral PAAs and abdominal aortic aneurysms (P < .05). PAAs in women were more likely to be symptomatic before surgery (65.5% vs 49.4%; P = .017), with 19% of women presenting with acute limb ischemia (vs 11%; P = .067). Women had smaller aneurysm diameters than men (22.5 mm vs 27 mm; P = .004) and became symptomatic at smaller diameters (20 mm vs 26 mm; P = .002). Only 8.6% of women and 11.6% of men underwent endovascular aneurysm repair (P > .05); therefore, the perioperative outcome analysis focused on open surgical repair. In total, 23.5% of women and 16.9% of men developed perioperative complications (P > .05). There were no differences in major cardiovascular events (P > .05), but women showed a higher incidence of impaired wound healing (15.7% vs 7.2%; P = .05) and major amputation (5.9% vs 1.1%; P = .027). Female sex was significantly associated with the need for nonvascular reinterventions within 30 days after surgery (odds ratio 2.48, 95% confidence interval 1.26-4.88), whereas no significant differences in the odds for vascular reinterventions were observed (odds ratio 1.98, 95% confidence interval 0.68-5.77). In the multiple logistic regression model, female sex, symptomatic PAAs, poor quality of outflow vessels, and graft material other than vein graft were independently associated with perioperative reinterventions.

CONCLUSIONS:

Women have smaller PAAs, are more likely to be symptomatic before treatment, and are more often affected by nonvascular reinterventions in the perioperative course. As our understanding of aneurysmatic diseases in women continues to expand, sex-specific treatment strategies and screening options for women in well-selected cohorts with modified screening protocols should be continuously re-evaluated.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Contexto en salud: 1_ASSA2030 Problema de salud: 1_desigualdade_iniquidade Asunto principal: Arteriopatías Oclusivas / Aneurisma de la Aorta Abdominal / Implantación de Prótesis Vascular / Procedimientos Endovasculares / Aneurisma de la Arteria Poplítea Límite: Female / Humans / Male Idioma: En Revista: J Vasc Surg Asunto de la revista: ANGIOLOGIA Año: 2024 Tipo del documento: Article

Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Contexto en salud: 1_ASSA2030 Problema de salud: 1_desigualdade_iniquidade Asunto principal: Arteriopatías Oclusivas / Aneurisma de la Aorta Abdominal / Implantación de Prótesis Vascular / Procedimientos Endovasculares / Aneurisma de la Arteria Poplítea Límite: Female / Humans / Male Idioma: En Revista: J Vasc Surg Asunto de la revista: ANGIOLOGIA Año: 2024 Tipo del documento: Article
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