The influence of gender on the outcome of arterial procedures in the lower extremity

Objectives: To determine the outcome of arterial reconstructive procedures, we audited retrospectively peripheral bypass grafts and endarterectomies performed between 1982 and 1990. Materials and Methods: 1005 peripheral arterial procedures were performed in 862 lower limbs in 782 patients. 62% of the limbs were critically ischaemic. The procedures include 565 bypasses, 346 endarterectomies and 94 combinations of both. 30% of the patients were women. Follow-up information was obtained from practitioners in charge of post-hospital care by questionnaires. Factors potentially affecting patency were investigated by multivariate analysis and patency rates were calculated by life-tables. Main results: Overall secondary patency was 61% at one year and 35% at 5 years. Bypasses and endarterectomies in women yielded lower patency rates than in men (49% vs. 67% at 1 year, p < 0.001). The relative risk of failure in women as compared to men was 1.30. The risk of failure was further increased by ''redo'' surgery (relative risk 1.51), diabetes (1.40), critical ischaemia (1.34) and crural procedures (1.34). Conclusions: Secondary patency rates were significantly lower in women than in men. This is in agreement with some other studies, although gender has gained little attention as a risk factor in vascular surgery.