showed excellent limb salvage rates of 93% for women and 88% for men at 10 years.45 They found no significant differences in long-term survival, primary rate, and secondary patency rates between women and men.45 Similar to other reports, women in this study were significantly older (71 years vs. 66 years), more often diabetic (53% vs. 50%), and less often smokers (27% vs. 44%) compared to men.45 A more recent report from Ballotta et al. showed comparable excellent results for 496 women and 837 men undergoing open infrainguinal arterial bypass with preferential autogenous vein graft.38 There were no significant differences in morbidity
and mortality rates between the two groups despite Inhibitors,research,lifescience,medical the fact that women were again a mean 3 years older than men and had
a higher incidence of diabetes.38 Ten-year limb salvage rates Inhibitors,research,lifescience,medical exceeded 90% in both men and women.38 Other investigators have reported worse limb salvage rates for women of Hispanic and Black races compared to Caucasian women and men,10, 11 although the underlying explanation for this race-based disparity has Inhibitors,research,lifescience,medical yet to be determined. AhChong et al. reported poorer primary and secondary graft patency rates in 93 women compared to 98 men undergoing infrainguinal bypass for critical limb ischemia. The authors postulate that the smaller-diameter target artery in women compared to men (median diameter 2.01 mm vs. 2.45 mm, respectively, P=.03)
may be contributing, at least in part, to the worse patency outcome.51 Currently, percutaneous endovascular interventions have emerged as Inhibitors,research,lifescience,medical the revascularization modality of choice for patients with infrainguinal occlusive disease, including those with critical limb-threatening ischemia. Surgical reconstruction is generally reserved as a second-line or salvage therapy. Several studies have demonstrated low complication rates and good limb-salvage rates following endovascular interventions on occluded femoropopliteal and tibial arteries, with comparable results for men and women.46, 52, 53 DeRubertis and coauthors showed selleck bio equivalent Inhibitors,research,lifescience,medical limb salvage and patency rates in women and men undergoing endovascular interventions for infrainguinal occlusive disease, even though the women had a higher prevalence of more advanced TASC C and D lesions (71% vs. 62%) and of critical limb ischemia (62% vs. 47%).46 Pulli et al. showed similar findings with Brefeldin_A excellent limb salvage rates and low periprocedural complication rates in both women and men.53 As shown in these series and numerous others, endovascular interventions for infrainguinal arterial lesions generally achieve limb salvage rates greater than 80-90%; however, the patency rates remain relatively low compared to those for iliac interventions, averaging a 40-50% primary patency rate at 1 to 2 years and between 50-80% primary-assisted patency rates.