Women compared to men had twice as much bleeding requiring transfusion, higher mortality, and more amputations.
USA: Women undergoing lower-extremity peripheral vascular intervention (PVI) are at higher risk compared to men of developing periprocedural complications, including amputation, bleeding, and death. This is the key finding of a study of real-world in-hospital outcomes which was published in Circulation: Cardiovascular Interventions.

Previous studies have shown that compared to men, women with coronary artery disease have worse outcomes after percutaneous coronary intervention, however, not much is known about sex-based outcomes following lower extremity PVI for symptomatic peripheral artery disease. S. Elissa Altin, Yale University School of Medicine, New Haven, CT (S.E.A.), and colleagues, therefore, aimed to assess whether female sex is independently associated with periprocedural complications in patients undergoing PVI.
The researchers included patients undergoing lower extremity PVI from September 2016 to March 2020 from the Vascular Quality Initiative registry. To assess the independent association of female sex with post-PVI complications, multivariate logistic regression was used.
Key findings include:
· Of the 119 620 patients included, 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), hematoma requiring transfusion (OR, 2.24), pseudoaneurysm (OR, 1.69), hematoma requiring surgery (OR, 1.49), and access site occlusion (OR, 1.89).
· Women also faced higher risks of target lesion dissection (OR, 1.36), above-knee amputation (OR, 1.37), and in-hospital mortality (OR, 1.21).
The researchers conclude, "women compared to men undergoing lower extremity PVI for symptomatic peripheral artery disease were at higher risk of developing periprocedural complications, including above-knee amputation, moderate or severe access site bleeding, and in-hospital mortality." They further noted that the increased risk persisted even after adjusting for differences in baseline patient or procedural characteristics and warrants further investigation.
Reference:
Altin SE, Gitto M, Secemsky EA, et al. Sex-based differences in periprocedural complications following lower extremity peripheral vascular intervention. Circ: Cardiovasc Intv. 2022;Epub ahead of print.