Aortoiliac occlusive disease in women.

Seventy-five women with aortoiliac (A-I) occlusive disease requiring vascular reconstruction during the past 4 years were reviewed. They represented a growing proportion (39%) of all patients with A-I disease And presented at the same meAn age (57 years) as males. Standard cardiovascular risk factors were high in this group and cigarette smoking was especially predominate (93%). Women presented with elevated triglyceride levels as opposed to increased cholesterol, with frequent type IV hyperlipoproteinemia. An operative mortality rate of 0%, a 4-year graft limb patency of 94%, and a 4-year life-table survival of 93% were observed. Good or excellent long-term relief of symptoms occurred in 96% of patients despite tandem ((superficial femoral) disease in 42% but only 4% superficial femoral reconstruction. A definition of women with "small vessels" was established by using aortic diameter > 1 SD below the overall mean (> 1 cm diameter at the aortic bifurcation). Women in this subgroup presented at a younger age with less severe symptoms, fewer risk factors, and more localized disease. An emphasis on postoperative reduction of cigarette smoking and dietary modification among hyperlipidemic patients probably contributed to the satisfactory results achieved in this increasing percentage of women with A-I occlusive disease.