Patient Sex and Success of Peripheral Percutaneous Transluminal Arterial Angioplasty

Abstract

Female sex negatively affects the durability of percutaneous angioplasty of native arteries supplying the lower extremity. Outcome analysis of the results of percutaneous angioplasty of lower extremity arteries in a single vascular surgery practice. University-affiliated community hospital. All patients undergoing percutaneous intervention on lower extremity arteries during 10 years. Indication for intervention, anatomic site of intervention, placement of percutaneous stents, and length of lesion undergoing angioplasty were noted. Patient demographics and risk factors were identified. Results were analyzed by sex. Kaplan-Meier life tables were plotted and differences between groups tested by the log-rank method. A Cox proportional hazards regression model was used to perform the multivariate analysis. During 10 years, 351 angioplasties were performed in 248 patients, 173 in women and 178 in men. There was no difference between men and women in indication for intervention, length and type of lesion treated, or quality of distal runoff. Univariate survival analysis identified a difference in duration of patency between men and women (P = .047). However, multivariate analysis demonstrated no significant difference in duration of patency between men and women (P = .18). Iliac angioplasty and adequate distal runoff were positive predictors of long-term patency (P<.001 for both). There appears to be no significant difference in the durability of angioplasty between men and women. However, location of angioplasty and adequacy of distal runoff may be useful in determining when to use angioplasty.