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"SHE" is at Risk: Analysis of Clinical Profiles, Interventions and Outcomes of Peripheral Arterial Disease in Women over a Period of 15 Years from India

Author(s): Rajendra Prasad Basavanthappa, Adharsh Kumar Maruthu Pandian, Ashwini Naveen Gangadharan

Background: Peripheral arterial disease (PAD) is gaining equal status like Coronary artery disease (CAD) and Cerebrovascular accident (CVA) worldwide in terms of morbidity, economic issues and mortality. Females with PAD exhibit more of asymptomatic/ subclinical disease pattern. Any gender-based differences in terms of clinical profiles and treatment outcomes of PAD is crucial to be studied. Our study is a first of its kind in Indian subcontinent analysing only female PAD patients.

Objective: The purpose of this article is to assess the risk factor profiles, natural course of the disease, varied treatment options and their outcomes in different age groups of female PAD population coming to our centre.

Methods: This is a retrospective study and included all female patients who were diagnosed with PAD between the age group of 25 to 90 years and either underwent Vascular intervention or had conservative treatment for the same at Ramaiah medical college hospital, Bangalore, over a period of 15 years from 2004 to 2018.

Results: The mean age of all cases was 59.41 years. Most common risk factors were “diabetes mellitus” (54.6%), “hypertension” (42.9%) and obesity (35.9%). Aorto Iliac segment interventions were done in 27 cases, SFA & popliteal in 195 cases and infra-popliteal in 81 cases. Technical success rate of open procedures was 96 % and for endovascular 90%. Major complications encountered were groin infection, hematoma, nephropathy and distal embolization. In a follow-up of 1 year, 48 patients succumbed to death due to coronary event and 66 of them required re-intervention due to either bypass graft thrombosis or new tissue loss.

Conclusion: PAD in females remains a major healthcare problem in our community, often due to delayed presentation and self-neglect, which leads to financial burden, increased risk of coronary or limb related adverse events and mortality in this population.

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