{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,30]],"date-time":"2026-09-30T22:43:42Z","timestamp":1790808222731,"version":"4.1.0"},"reference-count":22,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"17","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["JAHA"],"published-print":{"date-parts":[[2019,9,3]]},"abstract":"<jats:sec xml:lang=\"en\">\n            <jats:title>Background<\/jats:title>\n            <jats:p xml:lang=\"en\">Limited data exist to describe factors that influence the use of different endovascular treatments for peripheral arterial disease. Therefore, we studied sex differences in the utilization of endovascular treatment modalities and their impact on arterial patency.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec xml:lang=\"en\">\n            <jats:title>Methods and Results<\/jats:title>\n            <jats:p xml:lang=\"en\">\n              We analyzed procedures from 2010 to 2016 in the Vascular Quality Initiative for arteries treated with percutaneous transluminal angioplasty (\n              <jats:styled-content style=\"fixed-case\">PTA<\/jats:styled-content>\n              ) alone, stenting (with\/without\n              <jats:styled-content style=\"fixed-case\">PTA<\/jats:styled-content>\n              ), and atherectomy (with\/without\n              <jats:styled-content style=\"fixed-case\">PTA<\/jats:styled-content>\n              ). We explored sex differences in treatment modality by arterial segment (iliac, femoropopliteal, and tibial) with multivariable logistic regression. We used Kaplan\u2013Meier survival analysis and multivariable Cox regression to study sex differences in arterial reintervention and occlusion. In this cohort, patients (n=58\u00a0247, mean age 68\u00a0years, 41% women,) had 106\u00a0073 arteries treated (median=2 arteries, interquartile range=1\u20133). Half (50%) of these arteries were treated with stents, 39% with\n              <jats:styled-content style=\"fixed-case\">PTA<\/jats:styled-content>\n              alone, and 11% with atherectomy. After risk adjustment, women were less likely to undergo stenting or atherectomy (versus\n              <jats:styled-content style=\"fixed-case\">PTA<\/jats:styled-content>\n              alone) in the femoropopliteal (stent risk ratio=0.78 [0.74\u20130.82]; atherectomy risk ratio=0.69 [0.58\u20130.82]) and tibial arteries (stent risk ratio=0.70 [0.55\u20130.89]; atherectomy risk ratio=0.87 [0.70\u20131.07]). In the iliac arteries there was no sex difference in stenting, and atherectomy was rarely used (0.2%). Women underwent reintervention in the femoropopliteal arteries (hazard ratio=1.28 [1.17\u20131.40]) or developed an occlusion in the iliac (hazard ratio=1.42 [1.12\u20131.81]) and femoropopliteal arteries (hazard ratio=1.19 [1.06\u20131.34]) more frequently than men.\n            <\/jats:p>\n          <\/jats:sec>\n          <jats:sec xml:lang=\"en\">\n            <jats:title>Conclusions<\/jats:title>\n            <jats:p xml:lang=\"en\">Women were less likely to undergo stenting or atherectomy and had higher rates of occlusion and reintervention, especially in the femoropopliteal arteries. Evidence\u2010based guidelines are needed to guide optimal use of endovascular treatments for men and women.<\/jats:p>\n          <\/jats:sec>","DOI":"10.1161\/jaha.119.013088","type":"journal-article","created":{"date-parts":[[2019,8,31]],"date-time":"2019-08-31T09:08:31Z","timestamp":1567242511000},"update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":34,"title":["Role of Sex in Determining Treatment Type for Patients Undergoing Endovascular Lower Extremity Revascularization"],"prefix":"10.1161","volume":"8","author":[{"given":"Niveditta","family":"Ramkumar","sequence":"first","affiliation":[{"name":"The Dartmouth Institute for Health Policy and Clinical Practice Lebanon NH"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bjoern D.","family":"Suckow","sequence":"additional","affiliation":[{"name":"Section\u00a0of Vascular Surgery Department of Surgery Dartmouth\u2010Hitchcock Medical Center Lebanon NH"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jeremiah R.","family":"Brown","sequence":"additional","affiliation":[{"name":"The Dartmouth Institute for Health Policy and Clinical Practice Lebanon NH"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Art","family":"Sedrakyan","sequence":"additional","affiliation":[{"name":"Weill Cornell Medical College Cornell University New York NY"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Todd","family":"MacKenzie","sequence":"additional","affiliation":[{"name":"The Dartmouth Institute for Health Policy and Clinical Practice Lebanon NH"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David H.","family":"Stone","sequence":"additional","affiliation":[{"name":"Section\u00a0of Vascular Surgery Department of Surgery Dartmouth\u2010Hitchcock Medical Center Lebanon NH"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jack L.","family":"Cronenwett","sequence":"additional","affiliation":[{"name":"Section\u00a0of Vascular Surgery Department of Surgery Dartmouth\u2010Hitchcock Medical Center Lebanon NH"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Philip P.","family":"Goodney","sequence":"additional","affiliation":[{"name":"The Dartmouth Institute for Health Policy and Clinical Practice Lebanon NH"},{"name":"Section\u00a0of Vascular Surgery Department of Surgery Dartmouth\u2010Hitchcock Medical Center Lebanon NH"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","reference":[{"key":"e_1_3_1_2_2","doi-asserted-by":"publisher","DOI":"10.1097\/HCR.0b013e31818c3b96"},{"key":"e_1_3_1_3_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.avsg.2010.08.006"},{"key":"e_1_3_1_4_2","first-page":"251","article-title":"Contemporary outcomes of endovascular intervention for critical limb ischemia","volume":"6","author":"Dalal PK","unstructured":"Dalal PK. Contemporary outcomes of endovascular intervention for critical limb ischemia. Interv Cardiol Clin. 6:251\u2013259.","journal-title":"Interv Cardiol Clin"},{"key":"e_1_3_1_5_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jvs.2008.11.054"},{"key":"e_1_3_1_6_2","doi-asserted-by":"publisher","DOI":"10.3400\/avd.tasc.15-01000"},{"key":"e_1_3_1_7_2","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCRESAHA.116.303503"},{"key":"e_1_3_1_8_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jvs.2009.01.035"},{"key":"e_1_3_1_9_2","doi-asserted-by":"publisher","DOI":"10.1177\/1538574411418008"},{"key":"e_1_3_1_10_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jvs.2010.05.106"},{"key":"e_1_3_1_11_2","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCULATIONAHA.106.621391"},{"key":"e_1_3_1_12_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa051303"},{"key":"e_1_3_1_13_2","doi-asserted-by":"publisher","DOI":"10.1583\/11-3627.1"},{"key":"e_1_3_1_14_2","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCINTERVENTIONS.117.005749"},{"key":"e_1_3_1_15_2","doi-asserted-by":"publisher","DOI":"10.1067\/mva.2001.117148"},{"key":"e_1_3_1_16_2","doi-asserted-by":"publisher","DOI":"10.1067\/mva.2003.99"},{"key":"e_1_3_1_17_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jvs.2012.03.016"},{"key":"e_1_3_1_18_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jvs.2013.07.114"},{"key":"e_1_3_1_19_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2007.03.056"},{"key":"e_1_3_1_20_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.ejvs.2006.09.024"},{"key":"e_1_3_1_21_2","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.e5208"},{"key":"e_1_3_1_22_2","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCOUTCOMES.111.962233"},{"key":"e_1_3_1_23_2","doi-asserted-by":"publisher","DOI":"10.1258\/vasc.2010.ra0042"}],"container-title":["Journal of the American Heart Association"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.ahajournals.org\/doi\/full\/10.1161\/JAHA.119.013088","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,5,13]],"date-time":"2024-05-13T11:36:22Z","timestamp":1715600182000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.ahajournals.org\/doi\/10.1161\/JAHA.119.013088"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2019,9,3]]},"references-count":22,"journal-issue":{"issue":"17","published-print":{"date-parts":[[2019,9,3]]}},"alternative-id":["10.1161\/JAHA.119.013088"],"URL":"https:\/\/doi.org\/10.1161\/jaha.119.013088","relation":{},"ISSN":["2047-9980"],"issn-type":[{"value":"2047-9980","type":"electronic"}],"subject":[],"published":{"date-parts":[[2019,9,3]]},"assertion":[{"value":"2019-05-01","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2019-06-27","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2019-08-31","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"e013088"}}