Female Gender is a Predictor of Lower Iliac Vein Stenting Patency Rates
| Autor: | Patrick Cherfan, Zein Saadeddin, Mohamed S. Zaghloul, Catherine Go, Efthymios D. Avgerinos, Othman Abdul-Malak, Rabih A. Chaer, Georges E. Al-Khoury |
|---|---|
| Rok vydání: | 2022 |
| Předmět: |
Adult
Male medicine.medical_specialty Time Factors medicine.medical_treatment Iliac Vein Single Center Logistic regression Risk Assessment Article Sex Factors Risk Factors medicine Humans Vein Vascular Patency Aged Retrospective Studies Venous Thrombosis business.industry Proportional hazards model Endovascular Procedures Stent Health Status Disparities General Medicine Middle Aged Surgery Treatment Outcome medicine.anatomical_structure Leg edema Male patient Cohort Female Stents Cardiology and Cardiovascular Medicine business |
| Zdroj: | Ann Vasc Surg |
| ISSN: | 0890-5096 |
| DOI: | 10.1016/j.avsg.2021.06.027 |
| Popis: | Background Iliac venous stenting (IVS) for thrombotic and nonthrombotic venous disease is increasingly used as evidence of the safety, efficacy and durability of these interventions increases. Female gender has been implicated as a predictor of failure in arterial endovascular interventions. We hypothesize that female gender could be predictive of patency rates of iliac vein stenting. Methods Consecutive patients who underwent IVS for thrombotic or nonthrombotic venous disease at our institution from 2007 until 2019 were identified and divided into groups based on gender. Operative notes, venograms, and the electronic health record were then queried to obtain operative details, co-morbid conditions, postoperative outcomes and stent patency. Study outcome was long term patency rate. The data was analyzed using chi-square, logistic regression, and Kaplan-Meier analysis as appropriate. Results A total of 200 consecutive patients (231 limbs) were identified in our retrospective analysis, with a mean age of 48.8 ± 17.3, and BMI of 31.6 ± 8.6. Of those, 119 (59.5%) patients, (131 [56.8%] limbs) were female. Comparisons between the gender groups revealed no difference in age, BMI, or preoperative comorbidities. There was no difference in type of venous disease between male (85% thrombotic, 15% nonthrombotic) and female (84% thrombotic, 16% nonthrombotic), P= 0.830. The male cohort was more likely to present with leg ulceration (17% vs. 4.6%, P = 0.002), and the female cohort was more likely to present with leg edema (98.5% vs. 93.0%, P= 0.03). The male cohort had a higher rate of caval (48% vs. 33.6%, P= 0.027) and infrainguinal stent extension. (11% vs. 6.9%, P= 0.02). Females had a higher rate of left sided stenting (80.9% vs. 66/0%, P= 0.010). There was no difference in the median stent diameter used between the cohorts. Primary patency at 5 years was significantly higher for the male cohort (94.1% vs. 74.4%, P= 0.01) On adjusted multivariable cox regression female gender was a predictor of loss of primary patency within 5 years (HR, 4.04; P= 0.007). Conclusions In this single center retrospective analysis of IVS, male patients were found to have better primary stent patency compared to female. |
| Databáze: | OpenAIRE |
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