比较肾下腹主动脉瘤血管内修复患者性别差异的横断面多中心研究。圣保罗州立大学省级医院登记处（RHEUNI）的结果。
Cross-sectional, multicenter study comparing sex differences in patients undergoing endovascular repair of infrarenal abdominal aortic aneurysms. Results from the São Paulo State University Provincial Hospitals Registry (RHEUNI).
作者信息
Moura Regina, Joviliano Edwaldo Edner, Guillaumon Ana Terezinha, Raymundo Selma Regina de Oliveira, Hafner Ludwig, Sobreira Marcone Lima, de Almeida Marcelo José, Miquelin Daniel Gustavo, Geiger Martin, Yoshida Winston Bonetti
机构信息
Universidade Estadual Paulista - UNESP, Faculdade de Medicina de Botucatu, Botucatu, SP, Brasil.
Universidade de São Paulo - USP, Faculdade de Medicina de Ribeirão Preto, Ribeirão Preto, SP, Brasil.
出版信息
J Vasc Bras. 2024 Oct 28;23:e20240004. doi: 10.1590/1677-5449.202400042. eCollection 2024.
BACKGROUND
Abdominal aortic aneurysms (AAA) are 4-6 times more frequent among men than among women, but prognosis tends to be worse in women.
OBJECTIVE
To compare endovascular procedures to repair infrarenal AAA in men and women, using data from a prospective registry.
METHODS
This registry collected data from five university hospitals in the state of São Paulo (Brazil) from 2012 to 2022. A cross-sectional study was conducted compiling demographic data, anatomic variables (aneurysm diameter, short neck, angulated neck, calcified neck, or thrombosed neck; distal neck < 1.5 cm, and tortuous, abnormal iliac arteries), complications (leaks, conversions, and patency or stenosis of branches) and renal failure and mortality at 30 days. The chi-square test and Student's test were applied with a 5% significance level. The study was approved by the Ethics Committee (process 4040-2011).
RESULTS
A total of 152 (15.9%) of the patients were women and 799 (84.0%) were men (p < 0.05). The majority were white (80.2% of the women and 87.4% of the men). Diabetes and hypertension were significantly more frequent among the women. The most prevalent shape was fusiform, particularly among the women (95.39% vs. 89.86% among men). Mean diameter was smaller among the women (5.96 cm vs. 6.49 cm; p = 0.0056). The iliac arteries were less often involved among the women (89.40% vs. 73.58%; p = 0.00001). Blood loss was greater in the men (321.40 ml vs. 168.84 ml among the women; p < 0.05). Operative mortality was similar in both sexes, but obstructions were more frequent among the women (15.2% vs. 13.51%; p = 0.017296).
CONCLUSIONS
Aneurysmal diameter was smaller and obstructive complications were more frequent among women.
背景
腹主动脉瘤（AAA）在男性中的发病率是女性的4至6倍，但女性的预后往往更差。
目的
利用前瞻性登记数据，比较男性和女性行肾下AAA腔内修复术的情况。
方法
该登记处收集了2012年至2022年巴西圣保罗州五家大学医院的数据。进行了一项横断面研究，汇总人口统计学数据、解剖学变量（动脉瘤直径、短颈、成角颈、钙化颈或血栓形成颈；远端颈<1.5 cm，以及髂动脉迂曲、异常）、并发症（渗漏、中转，以及分支通畅或狭窄）以及30天时的肾衰竭和死亡率。采用卡方检验和学生t检验，显著性水平为5%。该研究经伦理委员会批准（流程4040 - 2011）。
结果
共有152名（15.9%）患者为女性，799名（84.0%）为男性（p < 0.05）。大多数为白人（女性中占80.2%，男性中占87.4%）。糖尿病和高血压在女性中明显更为常见。最常见的形状是梭形，尤其是在女性中（95.39%对男性中的89.86%）。女性的平均直径较小（5.96 cm对6.49 cm；p = 0.0056）。女性髂动脉受累的情况较少（89.40%对73.58%；p = 0.00001）。男性的失血量更大（321.40 ml对女性中的168.84 ml；p < 0.05）。两性的手术死亡率相似，但女性中梗阻更为常见（15.2%对13.51%；p = 0.017296）。
结论
女性的动脉瘤直径较小，梗阻性并发症更为常见。
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