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Gender is an independent risk factor for distribution pattern and lesion morphology in chronic critical limb ischemia

Jana Ortmann1, Eveline Nüesch, Tobias Traupe

  • 1Division of Clinical and Interventional Angiology, Swiss Cardiovascular Center, Bern University Hospital and University of Bern, Bern, Switzerland.

Journal of Vascular Surgery
|November 25, 2011
PubMed

Insights

Women with critical limb ischemia (CLI) experience more severe femoropopliteal artery disease and occlusions compared to men. This suggests gender influences atherosclerotic patterns in CLI, impacting detection and treatment strategies.

Area of Science:

  • Vascular Medicine
  • Atherosclerosis Research
  • Gender-Based Medicine

Background:

  • Critical limb ischemia (CLI) is a severe manifestation of peripheral artery disease.
  • Understanding gender differences in atherosclerotic lesion patterns is crucial for effective management.

Purpose of the Study:

  • To investigate gender-specific differences in the morphology and distribution of atherosclerotic lesions in patients with CLI.
  • To determine if female gender is an independent risk factor for specific lesion patterns in CLI.

Main Methods:

  • Prospective cohort study of 233 patients (134 men, 99 women) with CLI.
  • Evaluation of lower limb arterial tree lesions, categorized into iliac, femoropopliteal, and below-the-knee (BTK) disease.
  • Multivariable logistic regression models adjusted for cardiovascular risk factors to assess gender as an independent predictor.

Main Results:

  • Women with CLI were older and had higher rates of hypertension but lower rates of smoking compared to men.
  • Women showed a significantly higher risk for femoropopliteal lesions (OR, 2.53) and occlusions (OR, 3.81) compared to men.
  • Women had a higher risk for multilevel disease (OR, 3.81), while men were more likely to present with isolated BTK lesions (OR, 0.15).

Conclusions:

  • Female gender is an independent predictor of more severe femoropopliteal involvement and diffuse atherosclerotic disease in CLI.
  • Findings highlight the need for distinct early detection and treatment strategies for women with CLI.
  • Further research is warranted to explore confounding risk factors and their association with lesion morphology in CLI patients.
Abstract

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