Female Patients Have More Reinterventions after Lower Extremity Revascularization for Peripheral Arterial Disease.

OBJECTIVES: Reinterventions after lower extremity revascularization (LER) for peripheral arterial disease (PAD) are common. Previous studies observed increased reintervention rates in females; however, the frequency of reinterventions between males and females have not been compared. This study highlights sex differences in outcomes of LER focusing on reintervention patterns. METHODS: A retrospective analysis of patients undergoing LER for PAD between 2013-2020 at a tertiary care center was conducted. Perioperative and long-term outcomes were compared, as well as reinterventions after initial LER between males and females. RESULTS: 1,987 patients underwent LER, of whom 736 (37%) were female. Females were older (70.5 vs 69.2, p=0.015) and more likely to be Black (18% vs 12.3%, p=0.003). Males were more likely to have coronary artery disease (59.3% vs 45.6%, p<0.0001), diabetes (60.2% vs 51.9%, p=0.0003), and renal insufficiency (20.1% vs 15.8%, p=0.016). Perioperative complications were similar except return to OR, which was higher in males (17.7% vs 13.9%, p=0.029). After mean follow up of 3.1 years, there was no difference in major amputation or mortality. Kaplan-Meier survival curves showed no difference in freedom from MALE and MALE-free survival. Females were more likely to have two or more ipsilateral reinterventions (p=0.030) and higher mean ipsilateral reinterventions (2.0 ± 1.5 vs 1.7 ± 1.4, p=0.050). CONCLUSION: Despite fewer comorbidities, females underwent higher frequency of reinterventions with no difference in major amputation or mortality. Effectiveness of reinterventions in females versus males warrants further investigation.