Sex Differences in Peripheral Arterial Disease: Presentation, Treatment, and Outcomes

Area of Science:

• Vascular Medicine
• Cardiovascular Surgery
• Health Services Research

Background:

• Peripheral arterial disease (PAD) affects men and women differently, impacting risk factors, disease presentation, and treatment outcomes.
• Understanding these sex-based disparities is crucial for optimizing patient care and improving clinical results.

Purpose of the Study:

• To review and synthesize current evidence on sex-related differences in peripheral arterial disease (PAD).
• To examine variations in risk factors, disease distribution, endovascular therapy response, and surgical outcomes between sexes.

Main Methods:

• Systematic review of observational studies, registries, and randomized trials.
• Analysis of sex-based differences in PAD epidemiology, anatomy, treatment patterns, and clinical outcomes.

Main Results:

• Women with PAD are older, have more comorbidities, and present with atypical symptoms, leading to delayed diagnosis and more severe ischemia.
• Women exhibit smaller, more complex distal lesions and experience higher rates of repeat revascularization and periprocedural complications after endovascular therapy.
• Surgical outcomes show comparable limb salvage rates, though women may have longer hospital stays and more wound complications.

Conclusions:

• Significant sex differences exist in PAD presentation, anatomy, and outcomes, with women experiencing delayed diagnosis but achieving similar or better limb salvage.
• Earlier diagnosis, equitable medical therapy, and individualized treatment strategies are essential for managing PAD in women.
• Future research should prioritize sex-specific analyses to refine PAD management protocols and enhance patient outcomes.