From the Dartmouth Institute for Health Policy and Clinical Practice, Lebanon, NH (N.R., J.R.B., P.P.G.); Section of Vascular Surgery, Department of Surgery, Dartmouth-Hitchcock Medical Center, Lebanon, NH (B.D.S., J.L.C., P.P.G.); and Weill Cornell Medical College, Cornell University, New York, NY (A.S.).
Circ Cardiovasc Interv. 2018 Jan;11(1):e005749. doi: 10.1161/CIRCINTERVENTIONS.117.005749.
Limited evidence suggests that women and men might be treated differently for peripheral arterial disease. This analysis evaluated sex-based differences in disease presentation and its effect on treatment modality among patients who underwent endovascular treatment for peripheral arterial disease.
Using national registry data from the Vascular Quality Initiative between 2010 and 2013, we examined patient, limb, and artery characteristics by sex through descriptive statistics. We studied 26 750 procedures performed in 23 820 patients to treat 30 545 limbs and 44 804 arteries. Women presented at an older age (69 versus 67 years; <0.001) and were less often current or former smokers (72% versus 85%; <0.001). Transatlantic Inter-Society Consensus classification was similar among men and women (Transatlantic Inter-Society Consensus C or D: 37% in men versus 37% in women; =0.81), as was mean occlusion length (4.5 cm in men versus 4.6 cm in women; =0.04), even after accounting for lesion location. Women more frequently underwent treatment for rest pain (11% in men versus 16% in women; <0.001) versus claudication (59% in men versus 53% in women; <0.001) or tissue loss (28% in men versus 27% in women; =0.75). Treatment modality did not differ by sex but was associated with disease severity ( for trend <0.001) and lesion location ( for trend <0.001).
Women undergo peripheral endovascular intervention for peripheral arterial disease at an older age with critical limb ischemia. Treatment modalities do not vary by sex but are determined by disease severity and site. Although there exist sex differences in presentation, these differences do not lead to differential treatment for women with peripheral arterial disease.
有限的证据表明，女性和男性可能会因外周动脉疾病而接受不同的治疗。本分析评估了接受外周动脉疾病血管内治疗的患者中，疾病表现的性别差异及其对治疗方式的影响。
利用血管质量倡议（Vascular Quality Initiative）2010 年至 2013 年期间的全国登记数据，我们通过描述性统计方法按性别检查了患者、肢体和动脉特征。我们研究了 23820 例患者的 26750 例手术，以治疗 30545 条肢体和 44804 条动脉。女性就诊年龄较大（69 岁 vs. 67 岁；<0.001），且当前或以前吸烟者较少（72% vs. 85%；<0.001）。男性和女性的跨大西洋协会共识分类相似（跨大西洋协会共识 C 或 D：37%的男性 vs. 37%的女性；=0.81），平均闭塞长度也相似（男性 4.5cm vs. 女性 4.6cm；=0.04），即使考虑到病变位置。女性更常因静息痛（11%的男性 vs. 16%的女性；<0.001）而接受治疗，而不是因跛行（59%的男性 vs. 53%的女性；<0.001）或组织丧失（28%的男性 vs. 27%的女性；=0.75）。治疗方式不因性别而异，但与疾病严重程度（趋势<0.001）和病变部位（趋势<0.001）有关。
女性因严重肢体缺血而在外周血管内介入治疗外周动脉疾病时年龄较大。治疗方式不因性别而异，但取决于疾病严重程度和部位。尽管在外周动脉疾病患者的表现中存在性别差异，但这些差异不会导致女性患者的治疗方式不同。
