O-135 - A SEX-BASED ANALYSIS OF 5-YEAR OUTCOMES IN THE COVERED VERSUS BALLOON EXPANDABLE STENT TRIAL FOR THE TREATMENT OF AORTO-ILIAC OCCLUSIVE DISEASE.

TOPIC:
Peripheral Occlusive Arterial Disease
AUTHORS:
Barry I. (Royal Perth Hospital ~ Perth ~ Australia) , Macarulay R. (Royal Perth Hospital ~ Perth ~ Australia) , Ward N.C. (University of Western Australia ~ Perth ~ Australia) , Wong J. (Royal Perth Hospital ~ Perth ~ Australia) , Thomas S. (Prince of Wales Hospital ~ Sydney ~ Australia) , Vijayan V. (Ng Teng Fong General Hospital ~ Singapore ~ Singapore) , Puttaswamy V. (Royal North Shore Hospital ~ Sydney ~ Australia) , Jackson M. (Gold Coast University Hospital ~ Gold Coast ~ Australia) , Mwipatayi B.P. (Royal Perth Hospital ~ Perth ~ Australia)
Introduction:
The prevalence of peripheral arterial disease (PAD) in men and women differs with age, with males having a higher incidence of early onset symptomatic disease [1]. In contrast, females have an increasing prevalence later in life while they also have a propensity towards asymptomatic disease [2]. While a number of factors contribute to the success of operative intervention (i.e. concomitant co-morbidity burden, anatomical location of lesions) [3,4], the current literature demonstrates poorer outcomes in females post endovascular surgical intervention [5-8]. Indeed, female sex itself has been identified as an independent predictor of reduced primary latency following endovascular revascularisation [5,7,8]. This study aimed to evaluate the impact of sex on mid-term outcomes following stenting for aorto-iliac occlusive disease (AIOD).
Methods:
The COBEST study was carried out between January 2006 and December 2008. It allowed an assessment of the safety and efficacy of the covered stent (CS) compared with the bare metal stent (BMS) in the treatment of hemodynamically significant AIOD. The primary study endpoint of our analysis, assessed between the sexes, was the rate of primary patency five years following stenting for AIOD (inclusive of both CS and BMS).
Results:
Of the 168 lesions treated, 103 (61%) were in males and 65 (39%) were in females. Of the concomitant comorbidities, diabetes mellitus was significantly more common in females (17.5% vs. 41.5%, p = 0.006). Chronic limb threatening ischaemia (CLTI) at time of intervention was also more common in females, although not significantly (16.5% vs. 24.6%, p = 0.395). Despite this, sex was not associated with an impact on rate of primary patency (male; 0.70, 95% CI: 0.23 - 2.19, p = 0.543). In accounting for both male sex and the utilisation of BMS, nil significant impact was highlighted upon the rate of primary patency (HR: 3.43, 95% CI: 0.69 - 17.10, p = 0.133). All-cause mortality at 60 months was 22.6% in males compared to 19.4% in females (p = 0.695).
Conclusion:
No significant difference was identified in the rate of primary patency between the sexes. Further investigation is warranted to ascertain whether sex specific intervention guidelines are required.
References:
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