Adverse outcomes up for lower extremity PVI in females

(HealthDay)—Female patients undergoing lower extremity (LE)-peripheral vascular intervention (PVI) are at increased risk for adverse outcomes, but have similar procedural success as men, according to a study published online April 23 in the Journal of the American College of Cardiology.

Elizabeth A. Jackson, M.D., M.P.H., from the University of Michigan Health System in Ann Arbor, and colleagues examined gender-related differences in outcomes following percutaneous PVI procedures. Data were collected from 12,379 patients (41 percent female) who underwent LE-PVI from 2004 to 2009 at 16 hospitals from the Blue Cross Blue Shield Cardiovascular Consortium Peripheral Vascular Intervention (BMC2 PVI) registry.

The researchers found that female patients were older, had multilevel disease, and critical limb ischemia, compared with male patients. Female gender correlated with a higher rate of vascular complications, transfusions, and embolism in a propensity-matched analysis. In-hospital death, myocardial infarction, or stroke/transient ischemic attack did not differ between male and female patients. Among females, technical success was more commonly achieved (91.2 versus 89.1 percent; P = 0.014), but the overall procedural success rates were similar for men and women (79.7 and 81.6 percent, respectively; P = 0.08) due to increased complication rates for women.

"These data suggest the need for quality improvement interventions designed to improve medical therapy, and enhanced efforts to understand and ameliorate PVI associated complications, in particular bleeding and vascular complications among women," the authors write.

Several authors disclosed financial ties to the pharmaceutical, medical device, and insurance industries; BMC2 PVI was supported by an unrestricted grant from Blue Cross Blue Shield of Michigan.

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