Sex Differences in Endovascular Treatment of Isolated Popliteal Lesions

Purpose: Sex-based differences in peripheral arterial disease are well-known. Aim of this study was to evaluate sex-related disparities in patients undergoing endovascular treatment of isolated popliteal artery lesions.

Material and methods: Between 1th January 2004 and 1th January 2021 304 patients underwent endovascular treatment of an isolated popliteal artery lesion at three vascular centers. A retrospective analysis was performed comparing the outcomes in female versus male patients.

Results: The majority of the patients were female (51.3%). Male patients were younger (70.4 vs. 76.8 years, p < 0.01). Hyperlipidemia (62.2% vs. 45.5%, p < 0.01) and diabetes (62% vs. 40%, p < 0.01) were more common in male group. There were more current and former smokers in the male group (p = 0.04 and p = 0.01). There were no differences regarding lesion length (mean 94.5 mm) nor location of the lesion. Technical success was comparable in both groups 94.6% vs. 97.4%), no differences in terms of in-hospital complications (9.5% vs. 7.7%) were found. At 3 years estimates did not demonstrate any difference in terms of clinically driven target lesion revascularization (23% vs. 34%), secondary patency (86% vs. 96%), and all-cause mortality (77% vs. 67%) between the two groups.

Conclusion: In our experience the female sex showed clinical signs of popliteal artery lesion at higher age with less aggressive atherosclerotic risk factors. However, during the follow-up no sex-related significant differences were found in terms of morphological and clinical outcomes after endovascular revascularization.