Background:Women with coronary artery disease are shown to have worse outcomes after percutaneous coronary intervention compared with men; however, less is known about sex-based outcomes following lower extremity peripheral vascular intervention (PVI) for symptomatic peripheral artery disease. The study aims to assess whether female sex is independently associated with periprocedural complications in patients undergoing PVI.Methods:Analysis includes patients undergoing lower extremity PVI from September 2016 to March 2020 from the Vascular Quality Initiative registry. Multivariate logistic regression was used to assess the independent association of female sex with post-PVI complications.Results:Of the 119 620 patients included, 47 316 (39.6%) were women. Analysis reflected that women were at higher risk of developing access site complications, including any hematoma (odds ratio [OR], 1.45 [1.35–1.57]), hematoma requiring transfusion (OR, 2.24 [1.82–2.76]; P<0.001), hematoma requiring surgery (OR, 1.49 [1.19–1.86]; P<0.001), pseudoaneurysm (OR, 1.69 [1.39–2.05]; P<0.001), and access site occlusion (OR, 1.89 [1.15–3.08]; P<0.001). Women also faced higher risks of target lesion dissection (OR, 1.36 [1.26–1.46]; P<0.001), above-knee amputation (OR, 1.37 [1.18–1.58]; P<0.001), and in-hospital mortality (OR, 1.21 [1.07–1.38]; P=0.003).Conclusions:In a contemporary cohort, women undergoing lower extremity PVI for symptomatic peripheral artery disease were at higher risk than men of developing periprocedural complications, including moderate or severe access site bleeding, above-knee amputation, and in-hospital mortality. This increased risk persisted despite adjustment for differences in baseline patient or procedural characteristics and warrants further investigation.

中文翻译：

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下肢周围血管介入治疗后围手术期并发症的性别差异


背景：与男性相比，患有冠状动脉疾病的女性在经皮冠状动脉介入治疗后的预后较差；然而，对于针对症状性外周动脉疾病进行下肢外周血管介入治疗（PVI）后基于性别的结果知之甚少。该研究旨在评估女性是否与接受 PVI 的患者的围手术期并发症独立相关。方法：分析包括来自血管质量倡议登记处的 2016 年 9 月至 2020 年 3 月接受下肢 PVI 的患者。采用多变量逻辑回归评估女性性别与 PVI 后并发症的独立关联。结果：在纳入的 119 620 例患者中，47 316 例（39.6%）为女性。分析表明，女性发生通路部位并发症的风险较高，包括任何血肿（比值比 [OR]，1.45 [1.35–1.57]）、需要输血的血肿（OR，2.24 [1.82–2.76]； P <0 id= 160>P <0 id=161>P <0 id=162>P <0 id=163>P <0 id=164>P <0 id=165>P =0.003）。结论：在当代队列中，女性因有症状的外周动脉疾病而接受下肢 PVI 的患者发生围手术期并发症的风险高于男性，包括中度或重度入路部位出血、膝上截肢和院内死亡。尽管对基线患者或程序特征的差异进行了调整，但这种增加的风险仍然存在，值得进一步研究。