Results of surgical treatment for peripheral arterial occlusive disease in women

Background. The incidence and prevalence of peripheral arterial occlusive disease (PAOD) in women is more prevalent than generally appreciated, and the results of surgical treatment are not certain. The purpose of this study was to investigate the result of surgical treatment of PAOD in female patients in our service. Methods. Medical records of female patients undergoing surgical treatment for PAOD in Taipei Veteran General Hospital from January 1, 1997 to July 31, 1998 were reviewed retrospectively. The clinical variables were evaluated, including age, smoking, diabetes mellitus, hypertension, renal function, coexistent coronary disease, history of stroke, Fontaine stages, surgical procedures and results. Results. There were 20 female patients undergoing surgical treatment for PAOD during the study period, aged from 57 to 91 years, with an average of 73.7 ± 2.2. Four patients presented with rest pain. Twelve patients presented with gangrene of lower limbs. Ten patients underwent bypass surgery. Three patients received embolectomy. One patient underwent below knee amputation after femoro-popliteal bypass. One patient underwent below knee amputation after embolectomy. Five patients underwent above knee amputation without bypass surgery or embolectomy. Four patients (20%) died after surgery. Conclusions. The female patients of PAOD presented with severe symptoms and advanced Fontaine stages. The delay in diagnosis and referral resulted in an unsatisfying outcome of surgical treatment. An aggressive approach in diagnosis and referral is necessary for better results.