Mortality After Ruptured Abdominal Aortic Aneurysm Repair in Women (Open and Endovascular Approaches): A Literature...

Ruptured abdominal aortic aneurysm (rAAA) repair outcomes in women have not been extensively studied. The current work examines the outcomes after repair of rAAA in women compared to men. We further analyzed the specific outcomes depending on the type of repair including open surgical repair (OSR) and endovascular repair (EVAR).

We performed a systematic literature review and meta-analysis to evaluate the outcomes in women after rAAA repair in two subgroups, OSR and EVAR. For quality analysis, two reviewers obtained data from eligible studies, and utilizing the Newcastle-Ottawa Scale the quality of study designs and content was analyzed. A meta-analysis used version 4.2.3 of R software for OSR and EVAR short-term mortality. A random-effects model with inverse variance weighting was employed.

From the 765 citations initially found, four peer-reviewed articles met the inclusion criteria, with a total population of 25,465 patients, of which 5672 (22.3%) were women. Eighty-three percent underwent OSR, while 16.9% underwent EVAR. Short-term mortality after OSR demonstrated no difference between men and women (HR: 0.38, 95% CI: 0.33-43, P = 0.05). Short-term mortality after EVAR was no different between men and women (HR: 0.28, 95% CI: 0.22-0.34, P = 0.69).

This study provides valuable insights into the sex-specific nuances of rAAA repair outcomes. While no significant difference was found between men and women in short-term mortality after rAAA repair, likely a larger sample sizes and specific details regarding the indications to offer repair might be needed to be able to ascertain the true differences between men and women in the setting of rAAA.