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AIM: The purpose of this study was to examine the influence of aneurysm size on early outcome in women undergoing abdominal aortic aneurysm (AAA) repair, with suggestion of lowered threshold for intervention.
PATIENTS AND METHODS: Retrospective cohort study on the early outcome of 25 females undergoing elective endovascular (EVAR) and open AAA repair, compared to 340 males from 2005 to 2017. The study was focused on 30-days mortality (primary endpoint) and incidence of non fatal major adverse events – MAE (secondary endpoint) of two subgroups of women: AAA diameter <50 mm (n.14, group F1), AAA diameter ≥ 50mm (n.11, group F2).
RESULTS: The incidence of the primary endpoint at 30 days was 4% in females, and 1.1% in males, respectively (p=ns). Similarly, females showed a higher rate of MAE compared to males (16% vs 9.4%, p=ns). Women who underwent surgery with small aneurysms (F1 group) had an early outcome similar to men (30-day death 0% vs 1.1%, p=ns; MAE 7.1% vs 9.4%, p=ns) and significantly better than women with larger aneurysms (30-day death 0% vs 9%, p=ns; MAE 7.1% vs 27.2, p=ns).
CONCLUSIONS: Although poorly significant from a statistical point of view, the present report seems to confirm that the AAA diameter is a relevant marker of disease severity in women, assuming that repair at smaller size may be associated with less comorbidity and better outcome.