Effect Of Gender On Clinical Outcomes After Percutaneous Renal Artery Interventions
GABRIELA VELAZQUEZ RAMIREZ, MD, DAVID CROUSE, JEANETTE STAFFORD, MS, ASHLEY RICKEY, MD, NITIN GARG, MD, JUSTIN HURIE, MD, RANDOLPH GEARY, MD, MATTHEW EDWARDS, MD.
Wake Forest University School of Medicine, WINSTON-SALEM, NC, USA.
OBJECTIVES: Prior investigations have demonstrated inferior outcomes for females undergoing a variety of endovascular interventions. We hypothesized that female patients undergoing renal artery stenting (RA-PTAS) would experience more complications and inferior outcomes when compared to males
METHODS: Using an IRB-approved institutional vascular registry, consecutive patients undergoing RA-PTAS were selected for evaluation. Demographics, indications for revascularization, medical co-morbidities, procedural specifics, and outcomes were recorded and examined. Descriptive specifics were reported as count, or mean +/- SD. Gender associations were evaluated using Chi-Square or Fisher’s Exact test or t-test.
RESULTS: RA-PTAS was performed in 205 patients with renovascular hypertension due to arteriosclerotic disease. 107 (52%) patients were female, 25 (12%) patients were African American, and the mean age was 70 ± 11 years. BMI was higher in females (p=0.0383), while males showed higher serum creatinine (p=0.0004). No other statistically significant demographic or pre-intervention clinical characteristic differences were identified. Renal artery stent diameter (p=0.0003), and stent length (p=0.0053) were significantly larger in males. No differences in perioperative complications or outcomes were identified. Similarly, no significant gender differences were identified for change in serum creatinine (p=0.9153), EGFR (p=0.4416), systolic blood pressure (p=0.9772), diastolic blood pressure (p=4582), or number of medications required to control blood pressure (p=0.2354). 23 (45%) males and 21 (38%) females developed restenosis at follow up (p=0.4703). The number of ipsilateral reinterventions performed between males and females were 14 (14.3%) and 13(12.1%) respectively (p=0.6514).
CONCLUSIONS: Female patients undergoing RA-PTAS did not have a higher incidence of perioperative complications or any difference in renal function and blood pressure outcomes relative to males. Furthermore, despite having significantly smaller renal arteries treated with smaller stent diameters, females did not demonstrate a higher incidence of restenosis.
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