LAUSR

BACKGROUND Abdominal aortic aneurysms (AAAs) are more common in men. However, women have been shown to have more short- and long-term adverse outcomes after endovascular aneurysm repair (EVAR). This disparity is thought to be multifactorial, including anatomical differences, hormonal differences, older age of presentation, and a greater degree of preoperative comorbidities. METHODS A retrospective analysis that included data for 3758 patients from the Global Registry for Endovascular Aortic Treatment (GREAT) was conducted. Patients were recruited into GREAT between August 2010 and October 2016 and received the Gore Excluder stent graft for infrarenal AAAs repair. Cox multivariate regression analyses were performed to analyse any re-intervention and device related intervention rates. RESULTS Of the 3758 patients, 3220 were male (mean age 73 years) and 538 were female (mean age 75 years). Women had higher prevalence rates of chronic obstructive pulmonary disease (P <0.0001) and renal insufficiency (P = 0.03), whilst men had higher rates of cardiovascular comorbidities. The AAAs in women were smaller in diameter with shorter and more angulated necks. Women did not experience a significantly higher rate of endoleaks, but did exhibit higher re-intervention rates, including re-intervention for device related issues. In terms of mortality, aorta related mortality was most prevalent within the first 30 days post procedure in both sexes. CONCLUSION Women were treated at an older age and had a more hostile aneurysmal anatomy. Although the mortality rates were lower in women, they had significantly higher rates of re-intervention, and thus higher morbidity rates post EVAR.