Gender differences in patients treated for critical limb ischemia.

OBJECTIVE: To investigate, in patients treated for critical limb ischemia, how pre-operative conditions, localisation of lesions and outcome varied according to gender.
DESIGN: Retrospective cohort study.
METHODS: Medical records were analysed for all patients treated with vascular reconstruction or PTA for critical limb ischemia 1993-1994 (119 women, 115 men) at the Karolinska Hospital. All events such as secondary intervention, amputation and death occurring until 2003 were included in the analysis.
RESULTS: The preoperative conditions were similar between women and men apart from higher mean age (74 years in women vs 69 in men, p=0.0002), fewer subjects with a smoking history (63 vs 82%, p=0-005) and diabetic disease (22 vs 43%, p=0.0004) among females. More interventions were performed suprainguinally in women (44% in women vs 19% in men). Amputation and survival rates were similar in women and men, even after matching for age and diabetes.
CONCLUSION: Women were older, had a lower frequency of diabetes, smoked less and had more proximal lesions than treated men. Outcome was identical for both genders. Biological and anatomical differences could possibly explain several of the found gender differences. Gender differences in risk factors and possibly in the selection process also may have contributed to our findings.