Cross-sectional, multicenter study comparing sex differences in patients undergoing endovascular repair of infrarenal abdominal aortic aneurysms. Results from the São Paulo State University Provincial Hospitals Registry (RHEUNI)

Background Abdominal aortic aneurysms (AAA) are 4-6 times more frequent among men than among women, but prognosis tends to be worse in women. Objective To compare endovascular procedures to repair infrarenal AAA in men and women, using data from a prospective registry. Methods This registry collected data from five university hospitals in the state of São Paulo (Brazil) from 2012 to 2022. A cross-sectional study was conducted compiling demographic data, anatomic variables (aneurysm diameter, short neck, angulated neck, calcified neck, or thrombosed neck; distal neck < 1.5 cm, and tortuous, abnormal iliac arteries), complications (leaks, conversions, and patency or stenosis of branches) and renal failure and mortality at 30 days. The chi-square test and Student’s t test were applied with a 5% significance level. The study was approved by the Ethics Committee (process 4040-2011). Results A total of 152 (15.9%) of the patients were women and 799 (84.0%) were men (p < 0.05). The majority were white (80.2% of the women and 87.4% of the men). Diabetes and hypertension were significantly more frequent among the women. The most prevalent shape was fusiform, particularly among the women (95.39% vs. 89.86% among men). Mean diameter was smaller among the women (5.96 cm vs. 6.49 cm; p = 0.0056). The iliac arteries were less often involved among the women (89.40% vs. 73.58%; p = 0.00001). Blood loss was greater in the men (321.40 ml vs. 168.84 ml among the women; p < 0.05). Operative mortality was similar in both sexes, but obstructions were more frequent among the women (15.2% vs. 13.51%; p = 0.017296). Conclusions Aneurysmal diameter was smaller and obstructive complications were more frequent among women.