{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,30]],"date-time":"2026-09-30T22:43:45Z","timestamp":1790808225259,"version":"4.1.0"},"reference-count":29,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2023,3,15]],"date-time":"2023-03-15T00:00:00Z","timestamp":1678838400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/100000038","name":"U.S. Food and Drug Administration","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100000038","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000968","name":"American Heart Association","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100000968","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Cathet Cardio Intervent"],"published-print":{"date-parts":[[2023,4]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Endovascular peripheral vascular intervention (PVI) has become the primary revascularization technique used for peripheral artery disease (PAD). Yet, there is limited understanding of long\u2010term outcomes of PVI among women versus men. In this study, our objective was to investigate sex differences in the long\u2010term outcomes of patients undergoing PVI.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>We performed a cohort study of patients undergoing PVI for PAD from January 1, 2010 to September 30, 2015 using data in the Vascular Quality Initiative (VQI) registry. Patients were linked to fee\u2010for\u2010service Medicare claims to identify late outcomes including major amputation, reintervention, major adverse limb event (major amputation or reintervention [MALE]), and mortality. Sex differences in outcomes were evaluated using cumulative incidence curves, Gray's test, and mixed effects Cox proportional hazards regression accounting for patient and lesion characteristics using inverse probability weighted estimates.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>In this cohort of 15,437 patients, 44% (<jats:italic>n<\/jats:italic>\u2009=\u20096731) were women. Women were less likely to present with claudication than men (45% vs. 49%, <jats:italic>p<\/jats:italic>\u2009&lt;\u20090.001, absolute standardized difference, <jats:italic>d<\/jats:italic>\u2009=\u20090.08) or be able to ambulate independently (ambulatory: 70% vs. 76%, <jats:italic>p<\/jats:italic>\u2009&lt;\u20090.001, <jats:italic>d<\/jats:italic>\u2009=\u20090.14). There were no major sex differences in lesion characteristics, except for an increased frequency of tibial artery treatment in men (23% vs. 18% in women, <jats:italic>p<\/jats:italic>\u2009&lt;\u20090.001, <jats:italic>d<\/jats:italic>\u2009=\u20090.12). Among patients with claudication, women had a higher risk\u2010adjusted rate of major amputation (hazard ratio [HR]\u2009=\u20091.72, 95% confidence interval [CI]: 1.18\u20132.49), but a lower risk of mortality (HR\u2009=\u20090.86, 95% CI: 0.75\u20130.99). There were no sex differences in reintervention or MALE for patients with claudication. However, among patients with chronic limb\u2010threatening ischemia, women had a lower risk\u2010adjusted hazard of major amputation (HR\u2009=\u20090.79, 95% CI: 0.67\u20130.93), MALE (HR\u2009=\u20090.86, 95% CI: 0.78\u20130.96), and mortality (HR\u2009=\u20090.86, 95% CI: 0.79\u20130.94).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>There is significant heterogeneity in PVI outcomes among men and women, especially after stratifying by symptom severity. A lower overall mortality in women with claudication was accompanied by a higher risk of major amputation. Men with chronic limb\u2010threatening ischemia had a higher risk of major amputation, MALE, and mortality. Developing sex\u2010specific approaches to PVI that prioritizes limb outcomes in women can improve the quality of vascular care for men and women.<\/jats:p><\/jats:sec>","DOI":"10.1002\/ccd.30617","type":"journal-article","created":{"date-parts":[[2023,3,16]],"date-time":"2023-03-16T06:31:11Z","timestamp":1678948271000},"page":"877-887","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":14,"title":["Association between sex and long\u2010term outcomes of endovascular treatment for peripheral artery disease"],"prefix":"10.1002","volume":"101","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-4165-7426","authenticated-orcid":false,"given":"Niveditta","family":"Ramkumar","sequence":"first","affiliation":[{"name":"Geisel School of Medicine at Dartmouth Hanover New Hampshire USA"},{"name":"Dartmouth Institute for Health Policy and Clinical Practice Geisel School of Medicine at Dartmouth  Lebanon New Hampshire USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bjoern D.","family":"Suckow","sequence":"additional","affiliation":[{"name":"Section of Vascular Surgery, Department of Surgery Dartmouth\u2010Hitchcock Medical Center  Lebanon New Hampshire USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christian\u2010Alexander","family":"Behrendt","sequence":"additional","affiliation":[{"name":"Department of Vascular Medicine University Medical Center Hamburg\u2010Eppendorf Hamburg Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Todd A.","family":"Mackenzie","sequence":"additional","affiliation":[{"name":"Dartmouth Institute for Health Policy and Clinical Practice Geisel School of Medicine at Dartmouth  Lebanon New Hampshire USA"},{"name":"Department of Biomedical Data Science Geisel School of Medicine at Dartmouth Hanover New Hampshire USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Art","family":"Sedrakyan","sequence":"additional","affiliation":[{"name":"Department of Population Health Sciences Weill Cornell Medical College  New York New York USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jeremiah R.","family":"Brown","sequence":"additional","affiliation":[{"name":"Department of Epidemiology Geisel School of Medicine at Dartmouth Hanover New Hampshire USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Philip P.","family":"Goodney","sequence":"additional","affiliation":[{"name":"Dartmouth Institute for Health Policy and Clinical Practice Geisel School of Medicine at Dartmouth  Lebanon New Hampshire USA"},{"name":"Section of Vascular Surgery, Department of Surgery Dartmouth\u2010Hitchcock Medical Center  Lebanon New Hampshire USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2023,3,15]]},"reference":[{"key":"e_1_2_9_2_1","doi-asserted-by":"publisher","DOI":"10.1097\/HCR.0b013e31818c3b96"},{"key":"e_1_2_9_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.avsg.2010.08.006"},{"key":"e_1_2_9_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.iccl.2016.12.008"},{"key":"e_1_2_9_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jvs.2008.11.054"},{"key":"e_1_2_9_6_1","doi-asserted-by":"publisher","DOI":"10.3400\/avd.tasc.15-01000"},{"key":"e_1_2_9_7_1","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCRESAHA.116.303503"},{"key":"e_1_2_9_8_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jvs.2009.01.035"},{"key":"e_1_2_9_9_1","doi-asserted-by":"publisher","DOI":"10.1177\/1538574411418008"},{"key":"e_1_2_9_10_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jvs.2010.05.106"},{"key":"e_1_2_9_11_1","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCULATIONAHA.106.621391"},{"key":"e_1_2_9_12_1","doi-asserted-by":"publisher","DOI":"10.1067\/mva.2001.117148"},{"key":"e_1_2_9_13_1","doi-asserted-by":"publisher","DOI":"10.1067\/mva.2003.99"},{"key":"e_1_2_9_14_1","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCINTERVENTIONS.117.005749"},{"key":"e_1_2_9_15_1","doi-asserted-by":"publisher","DOI":"10.1161\/JAHA.119.013088"},{"key":"e_1_2_9_16_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jvs.2020.10.046"},{"key":"e_1_2_9_17_1","unstructured":"AHRQ.Society for Vascular Surgery Patient Safety Organization LLC. 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