Gender-based radiation exposure and clinical outcomes in peripheral endovascular intervention for limb ischemia: A prospective study

性别因素对肢体缺血外周血管介入治疗中辐射暴露和临床结局的影响:一项前瞻性研究

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Abstract

BACKGROUND: Peripheral endovascular intervention (PEVI) is performed using radiation. Radiation has deleterious health consequences for patients and operators. AIM: To investigate the gender radiation disparities and procedural outcomes in PEVI. METHODS: A prospective observational study was performed in 186 consecutive patients (65 ± 12 years) at an academic medical center from January 2019 to April 2020 (mean follow-up of 3.9 ± 3.6 months) comparing the gender radiation disparity and outcomes of PEVI (n = 147 underwent intervention, 79.0%). Groups were divided into women (n = 99, 53.2%) and men (n = 87, 48.4%). Primary endpoints included air kerma, dose area product (DAP), fluoroscopy time, and contrast use. Secondary endpoints included all-cause mortality, acute myocardial infarction, acute kidney injury, stroke, repeat revascularization, major adverse limb event, and the composite of complications. RESULTS: Men showed increased DAP compared with women (15221.2 ± 25858.5 µGy × m(2) vs 9251.7 ± 9555.3 µGy × m(2), P = 0.047), but no significant difference in air kerma or any other primary endpoints. In the secondary endpoints, no significant difference was found between gender. CONCLUSION: Men had increased DAP indicating more radiation absorption in the exposed area. Gender outcomes showed no difference in complications. Thus, PEVI can be safely performed in men or women.

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