Abstract 15391: Long-term Outcomes and Risk evaluation of patency in female infrainguinal arterial revascularization: Retrospective Multicenter Analysis
Introduction: In Peripheral artery disease, female gender is known as a risk of poor prognosis. But there is little report about female’s long-term results and risk factor of restenosis.
Hypothesis: We assessed the hypothesis that there is a trend toward poorer results in limbs of women underwent endovascular intervention therapy (EVT) rather than bypass surgery. The purpose of this study is to evaluate the long-term outcomes of endovascular and bypass infrainguinal revascularization in female.
Methods: This study was multicenter retrospective analysis from January 2004 to December 2009. 305 limbs (of 250 women) underwent infrainguinal arterial revascularization; endovascular therapy and bypass surgery was performed respectively in 206 limbs (EVT group) and 99 limbs (Bypass group). The two groups were compared in terms of demographic date and risk factor for atherosclerosis. Primary patency and secondary patency were assessed by either duplex ultrasound or angiography and analyzed by Kaplan-Meier estimation and compared by the log rank test. The determinants of restenosis were explored with Cox proportional hazard regression analysis.
Result: At 1, 3, 6 years, the primary patency rate were 58.3%, 42.6%, 28.3% (EVT group); 61.6%, 58.4%, 43.3% (Bypass Group) (log-rank test, p= N.S.). Secondary patency rates were 89.3%, 84.1%, 81.1% and 71.9%, 66.7%, 47.4% (log-rank test, p= 0.0001). Cox regression analysis identified hemodialysis (HR1.41; 95% CI 1.02 to 1.95, p=0.039), critical limb ischemia (HR 1.82; 95% CI 1.10 to 3.04, p=0.021), TASCIIC/D lesion (HR 3.64; 95% CI 1.84 to 7.14, p=0.0002) as the risk factor of female infrainguinal artery restenosis.
Conclusion: Long-term primary patency of endovascular therapy for female infrainguinal lesion is acceptable, compared with bypass surgery. Hemodialysis, critical limb ischemia, TASCIIC/D lesion is the risk factor of female associated with restenosis after infrainguinal revascularization.
- © 2012 by American Heart Association, Inc.