Mind the Gap: Women and Aortic Aneurysms w/ C. Fernandez-Prendes & A.-L. Pouncey

Join us for a compelling episode of the ESVS Podcast as we explore the sex disparities in aortic disease with two experts in aortic surgery in women — Dr. Carlota Fernandez-Prendes and Dr. Anna-Louise Pouncey.

In this episode, we discuss why women remain under-represented in clinical trials, which subgroups may benefit most from targeted screening, and why women face higher complication rates after both open and endovascular aneurysm repair in the immediate perioperative period.

We also examine the underlying causes of these differences and how vascular surgeons can optimise outcomes for their female patients.

This episode underscores the importance of heightened clinical awareness and tailored research. Stay tuned until the end for key insights on aortic aneurysm in women.

Referenced articles:

Talvitie M, Åldstedt-Nyrønning L, Stenman M, Roy J, Cohnert T, Hultgren R. Women with large intact abdominal aortic aneurysms remain untreated. J Vasc Surg. 2023;78(3):657–667. doi:10.1016/j.jvs.2023.05.025.

O’Donnell TFX, Patel PB, Marcaccio CL, Dansey KD, Swerdlow NJ, Rastogi V, Patel VI, Beck AW, Zettervall SL, Schermerhorn ML. Outcomes of complex endovascular treatment of post-dissection aneurysms. Eur J Vasc Endovasc Surg. 2023;66(1):58–66. doi:10.1016/j.ejvs.2023.04.013.

Gorgatti F, Nana P, Panuccio G, Rohlffs F, Torrealba JI, Kölbel T. Post-dissection thoraco-abdominal aortic aneurysm managed by fenestrated or branched endovascular aortic repair. Eur J Vasc Endovasc Surg. 2024;68(3):325–334. doi:10.1016/j.ejvs.2024.04.041.

Huckaby LV, Sultan I, Trimarchi S, Leshnower B, Chen EP, Brinster DR, et al. Sex-based aortic dissection outcomes from the International Registry of Acute Aortic Dissection. Ann Thorac Surg. 2022;113(2):498–505. doi:10.1016/j.athoracsur.2021.03.100.

Tenorio ER, Oderich GS, Farber MA, Schneider DB, Timaran CH, Schanzer A, et al. Outcomes of endovascular repair of chronic postdissection compared with degenerative thoracoabdominal aortic aneurysms using fenestrated-branched stent grafts. J Vasc Surg. 2020;72(3):822–836. doi:10.1016/j.jvs.2019.10.091.

Lo RC, Bensley RP, Hamdan AD, Wyers M, Adams JE, Schermerhorn ML; Vascular Study Group of New England. Gender differences in abdominal aortic aneurysm presentation, repair, and mortality in the Vascular Study Group of New England. J Vasc Surg. 2013;57(5):1261–1268.e5. doi:10.1016/j.jvs.2012.11.039.

Lancaster EM, Gologorsky R, Hull MM, Okuhn S, Solomon MD, Avins AL, et al. The natural history of large abdominal aortic aneurysms in patients without timely repair. J Vasc Surg. 2022;75(1):109–117. doi:10.1016/j.jvs.2021.07.125.

Bulder RMA, Tedjawirja VN, Hamming JF, Koelemay MJ, Balm R, Lindeman JHN; on behalf of the study group collaborators. Hypothesis of the high mortality of female patients following elective open abdominal aortic aneurysm repair. Eur J Vasc Endovasc Surg. 2022;63(5):773–774. doi:10.1016/j.ejvs.2022.01.018.

Pouncey AL, David M, Morris RI, Ulug P, Martin G, Bicknell C, Powell JT. Systematic review and meta-analysis of sex-specific differences in adverse events after open and endovascular intact abdominal aortic aneurysm repair: consistently worse outcomes for women. Eur J Vasc Endovasc Surg. 2021;62(3):367–378. doi:10.1016/j.ejvs.2021.05.029.

O’Donnell TFX, Verhagen HJ, Pratesi G, Pratesi C, Teijink JAW, Vermassen FEG, et al. Female sex is associated with comparable 5-year outcomes after contemporary endovascular aneurysm repair despite more challenging anatomy. J Vasc Surg. 2019;70(6):1782–1792.e2. doi:10.1016/j.jvs.2019.05.065.