Abdominal Aortic Aneurysms in Females: A Comparative Analysis

Abstract

The differences in nature, etiology, and outcome of abdominal aortic aneurysms (AAA) in females have received little attention. We retrospectively analyzed 23 females undergoing elective AAA repairs in the hands of one surgeon at Guthrie Clinic and compared them with agematched males from the same population undergoing elective AAA repairs over the same time period (19 years). AAAs were seen to have a male/female ratio of 8:1 and occur at a later age in females (73 years compared with 69 years). Females had less systemic atherosclerotic disease [coronary artery disease (CAD) in 15 males, 7 females; peripheral vascular disease (PVD) in 3 males, no females; cerebrovascular disease in 3 males, no females]. All other associated diseases were more common in females (hypercholesterolemia, 9 females, 1 male; hypertension, 15 females, 12 males; diabetes mellitus, 5 females, 3 males). Average aneurysm size was not significantly different (6.48 cm in females compared with 6.90 cm in males). Five females had significant renal artery involvement for which bypasses were done, whereas no males needed any procedures for renal arteries. There was no significant difference in postoperative morbidity and mortality. Long-term follow-up revealed a slight survival advantage for the males. The females with AAAs have more associated diseases (other than atherosclerosis) and have a decreased life expectancy.